Proton-Pump Inhibitors Initiated in the Intensive Care Unit Often Aren't Discontinued

Most intensive care units (ICUs) have bundles of care designed to protect patients from complications of critical illness. Proton-pump inhibitors (PPIs) for stress ulcer prophylaxis are a mainstay of this approach. However, these bundles often do not address stopping PPIs when they no longer are indicated. Investigators from Germany used health insurance data to identify more than 11,000 patients who began receiving PPIs during ICU admissions and did not have clearly identified (i.e., coded) indications for PPI use at 8 weeks after discharge.

Forty-two percent of patients had a PPI on their medication list without indication 8 weeks after discharge, and more than half of these patients still were using PPIs 1 year later. PPI continuation was…