McCaleb Rachael V, Gandhi Arpita S, Clark Stephen Michael, Clemmons Amber B
University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA Georgia Regents Medical Center, Augusta, GA, USA University of Georgia College of Pharmacy, Augusta, GA, USA.
Georgia Regents Medical Center, Augusta, GA, USA University of Georgia College of Pharmacy, Augusta, GA, USA
Ann Pharmacother. 2016 Jul;50(7):541-7. doi: 10.1177/1060028016644469. Epub 2016 Apr 18.
Acid suppressive therapy (AST)-namely, proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs)-is routinely prescribed to hospitalized patients for stress ulcer prophylaxis (SUP).
To identify the incidence of and indications for AST use in the hematology/oncology population as well as to identify the occurrence of the following PPI-associated adverse events: pneumonia and Clostridium difficile-associated diarrhea (CDAD).
A retrospective chart review was conducted on adult hematology/oncology patients admitted to any oncology service for ≥48 hours from October 1, 2014, to December 31, 2014.
Of the 298 patients who met the inclusion criteria, 73% (n = 218) received an AST during admission. The most common indication for an AST was SUP (63%). The incidence of hospital-acquired pneumonia (HAP) was 10%, 0%, and 4% in patients who received a PPI, H2RA, and no AST, respectively (14/142 vs 0/70 vs 3/80; odds ratio [OR] for PPI vs no AST = 2.68; 95% CI = 0.75-9.63). The incidence of CDAD was 3%, 1.3%, and 1.2% in patients who received a PPI, H2RA, and no AST, respectively (4/142 vs 1/70 vs 1/80; OR for PPI vs H2RA = 1.92; 95% CI = 0.21-17.47).
This is the first study to describe the incidence of and indications for AST use in the hospitalized hematology/oncology population. There was a high occurrence of AST use, particularly PPIs, in these patients at our institution. Additionally, there was a trend toward an increased risk of HAP and CDAD in patients who received AST during admission.
抑酸治疗（AST），即质子泵抑制剂（PPI）和组胺-2受体拮抗剂（H2RA），通常用于住院患者预防应激性溃疡（SUP）。
确定血液学/肿瘤学患者中AST的使用发生率和适应证，并确定以下与PPI相关的不良事件的发生情况：肺炎和艰难梭菌相关性腹泻（CDAD）。
对2014年10月1日至2014年12月31日入住任何肿瘤科室≥48小时的成年血液学/肿瘤学患者进行回顾性病历审查。
在符合纳入标准的298例患者中，73%（n = 218）在住院期间接受了AST治疗。AST最常见的适应证是SUP（63%）。接受PPI、H2RA和未接受AST治疗的患者中，医院获得性肺炎（HAP）的发生率分别为10%、0%和4%（14/142 vs 0/70 vs 3/80；PPI与未接受AST治疗相比的优势比[OR] = 2.68；95%CI = 0.75 - 9.63）。接受PPI、H2RA和未接受AST治疗的患者中，CDAD的发生率分别为3%、1.3%和1.2%（4/142 vs 1/70 vs 1/80；PPI与H2RA相比的OR = 1.92；95%CI = 0.21 - 17.47）。
这是第一项描述住院血液学/肿瘤学患者中AST使用发生率和适应证的研究。在我们机构的这些患者中，AST的使用发生率很高，尤其是PPI。此外，住院期间接受AST治疗的患者发生HAP和CDAD的风险有增加趋势。
