Utilización de supresores de la secreción ácida en pacientes hospitalizados

Abstract

The acid-suppressive medications are used frequently in hospitalized patients, but some studies suggests that their are overused, especially in the treatment of stress ulcer prophylaxis in low-risk patients. This research determine the frequency of use and indications of acid-suppressive medications in hospitalized patients in a internal medical service. A at random and retrospective revision of 209 medical records of 661 hospitalized patients during the year 2000 in the V Internal Medical Service of the General University Hospital of Gregorio Marañón (Cantoblanco). Use: any prescription of an acid-suppressive medication, regardless of dosage regimen, in which the patient received at least one dose. Appropriated indication: endoscopical criteria: treatment of active ulcer disease, esophagitis or gastritis. Medical criteria: symptomatic gastroesophageal reflux, dyspepsia, prolonging of previous treatment, as a part of a treatment regimen for H. pylori, relief of dyspepsia caused by nonsteroidal anti-inflammatory drugs, stress ulcer prophylaxis in high risk patients. Inappropriate indication: any other uses were considered not indicated. Of the 209 patients, a total of 157 (75.1%) received acid-suppressive therapy, average age 76 years old, 89 women (56.7%) and 68 men (43.3%). The admitting diagnoses for the admission were: CHF 34 (21.7%), Pneumonia (16.6%), UTI (15.3%) y COPD 18 (11.5%). The use in hospital ward was 84.7% (133), with inappropriate use 72.2% (96), the cause of prescription "no reason" 52.1% (50), and received proton pump inhibitors 46.9% (45). This study show a high frequency of incorrect use of acid-suppressive medications in hospitalized patients.