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Inappropriate Use of Proton Pump Inhibitors for Stress Ulcer Prophylaxis in a Tertiary Care Hospital: A Cross-Sectional Study

Year: 2025

Type: article

Abstract: BACKGROUND: Although proton pump inhibitors (PPIs) are extensively used for acid-related disorders, their inappropriate administration for stress ulcer prophylaxis (SUP) in hospitalized patients remains a cause for concern. This study aimed to evaluate the extent of PPI misuse for SUP in a tertiary care setting, identify contributing factors, and assess adherence to clinical guidelines. METHODOLOGY: A cross-sectional study was conducted over one year, including hospitalized patients receiving PPIs for SUP without documented indications. Data were collected through medical record reviews and physician questionnaires to determine prescription patterns, indications, and adherence to guidelines. Statistical analysis was performed using SPSS (IBM Corp., Armonk, NY, USA), employing chi-square tests and descriptive statistics. RESULTS: Among 274 patients, only 31.02% had appropriate indications for PPI use, while 68.98% received PPIs without meeting prophylactic criteria. Overall, 33.58% of prescriptions adhered to guidelines, whereas 66.42% deviated. The average duration of PPI use was 10.3 ± 4.7 days: 47.45% used PPIs for seven or fewer days, 31.02% for eight to 14 days, and 21.53% for more than 14 days. Guideline-based prescribing accounted for 35.77%, while 40.88% of prescriptions were attributed to defensive prescribing. Inappropriate PPI use was significantly associated with older age (p = 0.034) and ICU admission (p = 0.001). CONCLUSION: PPI overuse for stress ulcer prevention is prevalent among hospitalized patients. Targeted interventions are needed to improve adherence to evidence-based guidelines and curb unnecessary prescribing, particularly in relation to defensive medical practices.

Source: Cureus

DOI: 10.7759/cureus.83010

Authors: Sardar Alam, Sadia Iqbal Qureshi, Ali Shakeel, Atika Javed, Nayab Sami, Bilal Ahmad