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Stress ulcer prophylaxis use in critical care units at public hospitals in Johannesburg, South Africa.
Biyase, N; Perrie, H; Scribante, J; Muteba, M; Chetty, S.
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  • Biyase N; Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Perrie H; Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Scribante J; Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Muteba M; Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Chetty S; Department of Anaesthesiology and Critical Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
South Afr J Crit Care ; 37(1)2021.
Article en En | MEDLINE | ID: mdl-35498762
Background: Stress ulcer prophylaxis (SUP) is part of the management of critically ill patients in intensive care units (ICUs). However, inappropriate use of these drugs has important clinical implications such as ventilator-associated pneumonia and Clostridium difficile-associated gastrointestinal tract infections. The overuse of proton pump inhibitors (PPIs) as SUP is a rapidly growing problem globally. Objectives: To describe the use of SUP in three selected ICUs in Johannesburg, South Africa (SA). Methods: A retrospective, descriptive, contextual study design was used. Data were collected from ICU records of adult patients admitted into these units during the study period (1 August 2013 - 31 October 2013). Results: A total of 174 patients were included in the study. Of these, 156 were on SUP and only 38.5% (n=60/156) were appropriately treated with SUP according to the American Society of Health-System Pharmacists guidelines. There was an inappropriate use of SUP in over 50% of those who were treated. The most frequently prescribed SUP was histamine-2 receptor antagonist (H2RA) (51.3%; n=80/156), followed by PPIs (30.8%; n=48/156), sucralfate (17.3%; n=27/156), and a combination of PPI and H2RA (0.6%; n=1/156). Conclusion: The study demonstrated overuse of SUP. The most commonly used drug for SUP was H2RA and not PPIs. This study demonstrates that the problem of SUP overuse internationally also exists locally. The development of local guidelines may help to improve the practice of SUP in SA. Contributions of the study: This study showed overuse of SUP and should encourage doctors to critically evaluate why they prescribe SUP and whether it is really indicated. This should help in the adoption of practices towards appropriate use of SUP.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline Idioma: En Revista: South Afr J Crit Care Año: 2021 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Sudáfrica
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline Idioma: En Revista: South Afr J Crit Care Año: 2021 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Sudáfrica