Assessment of Stress Ulcer Prophylaxis Pattern in the Intensive Care Unit Patients

Aim: Stress ulcer prophylaxis (SUP) is often overused in the intensive care unit. Evaluation of the rate of unsuitable stress ulcer prophylaxis upon ICU admission and determine the frequency of overutilization or underutilization of SUP. Study design: This study was performed in Imam Khomeini Hospital of Urmia University of Medical Sciences in Iran. The risk of stress ulcer development was assessed using American Society of Health-System Pharmacists (ASHP) guideline. Materials and Methods: Patients with at least one major or two minor risk factors had an indication of receiving prophylactic stress ulcer. Stress ulcer prophylaxis was considered as appropriate if patients were in one of these two groups and receiving medication. Results: In total of 200 patients included in this study, 55.5% were male, mean hospitalization in ICU was 17.9±8.7 days. The mean age of patients was 56.1 ±17.4 years. Thirty two percent of patients had at least one major and 47.5% had at least two minor risk factors. The most common major risk factor was coagulopathy and the most minor risk factor was using heparin with therapeutic dose. Seventy-nine and a half percent of patients received stress ulcer prophylaxis based on guideline and forty-one (20.5%) had not any indication for stress ulcer prophylaxis and they received drugs inappropriately. The most commonly, used drug class in the prevention of stress ulcer was H2 blockers. Conclusions: Physicians are familiar with risk factors, but they are not familiar with the importance of rational prescription, and overuse of stress ulcer prophylaxis. So, we are far from ideal conditions.