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• W2977769897 abstract "Purpose: The FDA indications for IV PPIs are for short-term treatment (7 to 10 days) of GERD, with a history of erosive esophagitis and in a patient unable to take oral tablets, and for patients with pathological hypersecretion (Zollinger-Ellinson Syndrome). Other common uses are for stress ulcerpro-phylaxis (SUP) in patients with significant co-morbidities who cannot take oral therapy or an IV H2B and for prevention of recurrent GI bleeding (GIB). Our aim was to determine if IV PPIs are being inappropritely used at our institution. Methods: We utilized four indications for the use of an IV PPI. These included the two FDA approved indications: GERD therapy (40 mg IV qd) and Zollinger-Ellison Syndrome (80 mg IV bid) as well as two non-FDA approved indications: SUP (80 mg IV bolus over 5 minutes followed by 80 mg IV infusion bid) and GIB (80 mg IV bolus over 5 minutes followed by an infusion of 8 mg/hour for 72 hours). During a six-month period (July-Dec 2002) a total of 371 individual patients received an IV PPI. Charts were audited and the IV PPI was classified as appropriately or inappropriately indicated. Results: Of the 371 patients that received an IV PPI, 231 (62%) were classified as appropriately indicated and 140 (38%) inappropriately indicated. The appropriate indications were GIB (13%) and SUP with concomitant (a) GI disease [pancreatitis, esophagitis, gastroenteritis] (28%), (b) other non-GI disease [MI, sepsis, pneumonia, CVA, ARF] (47%) and (c) a post-operative state (12%). However, for SUP there was almost unifrorm derivation from the optimal dosing regimen. Conclusions: 1. Inappropriate utilization occurs in greater than one-third of patients and increases hospital costs even with expanding the appropriate indications to include SUP and prevention of recurrent GIB. 2. The most common utilization of IV PPIs are not the FDA-labeled indications, but common off-label uses, namely SUP and GIB. 3. This is in agreement with retrospective anlaysis that shows adherence to published indications of use and dosing of IV PPIs is poor, and corresponds to excessive costs. Indiscriminate use of IV PPIs may lead to adverse events and an unnecessary cost burden.[1]" @default.
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• W2977769897 date "2004-10-01" @default.
• W2977769897 modified "2023-09-25" @default.
• W2977769897 title "A PROSPECTIVE EVALUATION OF PHYSICIAN UNDERSTANDING OF INTRAVENOUS PANTOPRAZOLE (PROTONIX®) UTILIZATION" @default.
• W2977769897 doi "https://doi.org/10.14309/00000434-200410001-00736" @default.
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