Even though the practice is common, an article in Critical Care Nurse argues routine use of acid-suppressive therapy in intensive care unit patients is inappropriate.
Critically ill patients are at-risk for gastrointestinal bleeding and ulceration, which has led to widespread use of stress ulcer prophylaxis to preempt those conditions. However, the therapy can have negative effects and put patients at increased risk of pneumonia and Clostridium difficile infection.
"Suppressing gastric acid is necessary in select critically ill patients to reduce GI bleeding, but doing so also affects its effectiveness as an antiseptic barrier," said Andrew Faust, PharmD, one of the study's co-authors. "Preventing GI bleeding through acid-suppressive therapy, especially proton pump inhibitors, may increase a patient's risk for serious and potentially life-threatening infectious complications."
Dr. Faust and other authors urged using the therapy only when patients meet specific criteria and encouraged implementing a risk-scoring tool to cut down on overuse of SUP.