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Year : 2017  |  Volume : 1  |  Issue : 6  |  Page : 31-33

Stress ulcer prophylaxis: Back to square one

1 Department of Emergency and Critical Care, College of Medicine, Imam Abdulrahman Ben Faisal University, Dammam, Saudi Arabia
2 Department of Medicine, Division of Critical Care and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada

Correspondence Address:
Waleed Alhazzani
Department of Medicine, Division of Critical Care, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Avenue, Postal Code L8N 4A6, Hamilton, Ontario
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2543-1854.219136

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Pharmacologic prophylaxis against stress ulcer-related gastrointestinal (GI) bleeding with acid suppression has been the standard of care for decades. Worldwide, proton pump inhibitors (PPIs) are more commonly used than histamine-2-receptor antagonists. However, recent observational studies suggest that PPIs increase the risk of ventilator-associated pneumonia (VAP) and Clostridium difficile infection (CDI). Further, the incidence of GI bleeding appears to be lower than in the past, perhaps related to immediate resuscitation and enteral nutrition. a large randomized trial is needed to test the efficacy and safety of withholding PPIs in the ICU.

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