Parente F, Cucino C, Gallus S, Bargiggia S, Greco S, Pastore L, Bianchi Porro G
Department of Gastroenterology, L. Sacco University Hospital, Milan, Italy.
Aliment Pharmacol Ther. 2003 Jun 15;17(12):1503-6. doi: 10.1046/j.1365-2036.2003.01600.x.
Acid-suppressive medications are commonly used in hospitalized patients, but, to date, little is known about the overall use of these drugs in the hospital setting.
To evaluate the appropriateness of acid-suppressive therapy in a large teaching hospital in northern Italy, and the fall-out of hospital prescription in general practice.
The use of antisecretory agents was monitored for 1 month in adult patients consecutively admitted to L. Sacco University Hospital by reviewing their clinical charts. The appropriateness of each prescription was reviewed jointly by two consultant gastroenterologists.
A total of 46.8% of 799 hospitalized patients received acid-suppressive therapy. Ranitidine was the most frequently used drug (44.4%), followed by pantoprazole (31.8%) and omeprazole (23.0%). Stress ulcer prophylaxis and the prevention of non-steroidal anti-inflammatory drug-induced ulcer accounted for 60.4% of the indications for use. Overall, 68% of prescriptions were not appropriate as determined by consensus review; 56.4% of patients receiving unnecessary prophylactic treatment whilst in hospital were discharged on therapy, and 46% were still receiving the treatment 3 months later.
Acid-suppressive agents are over-used in hospitalized patients. Most of the inappropriate hospital prescriptions are for ulcer prophylaxis in low-risk patients. This unnecessary use may also induce inappropriate drug consumption in general practice.
抑酸药物在住院患者中普遍使用，但迄今为止，对于这些药物在医院环境中的整体使用情况知之甚少。
评估意大利北部一家大型教学医院中抑酸治疗的合理性，以及医院处方在全科医疗中的后续影响。
通过查阅临床病历，对连续入住L. Sacco大学医院的成年患者使用抗分泌药物的情况进行了1个月的监测。每份处方的合理性由两位胃肠病学顾问共同审查。
799名住院患者中，共有46.8%接受了抑酸治疗。雷尼替丁是最常用的药物（44.4%），其次是泮托拉唑（31.8%）和奥美拉唑（23.0%）。应激性溃疡预防和非甾体抗炎药所致溃疡的预防占用药指征的60.4%。总体而言，经共识审查确定，68%的处方不合理；6.4%接受不必要预防性治疗的住院患者出院时仍在接受治疗，46%的患者在3个月后仍在接受治疗。
住院患者中抑酸药物使用过度。大多数不合理的医院处方是用于低风险患者的溃疡预防。这种不必要的使用还可能导致全科医疗中药物的不当消费。
