Utilization of intravenous proton pump inhibitors

Due to the marked over-utilization of acid suppression in the hospital setting, the recommendations of this drug review aim to identify the evidence-based appropriate indications for use of IV PPIs. [...] In addition to patients requiring PPI therapy who are unable to take medication orally, the use of IV PPI in the management of UGIB was also reviewed. [...] Data on the cost-effectiveness of routine administration of IV PPI prior to endoscopy are disparate and are based on assumptions in the absence of direct clinical trials. [...] It is hoped that the evidence-based recommendations contained within the report will provide guidance to CAHO member hospitals in order to improve patient care, reduce variation in prescribing and utilization of IV PPIs and provide reasonable criteria for use of IV PPIs that can form the basis of a monitoring and audit program for this class of agents. [...] The goal of treatment is to stabilize the patient with appropriate resuscitation strategies, identify the source of bleeding, identify the criteria for rebleeding and treat appropriately.