三级转诊医院住院犬质子泵抑制剂给药的评估。
Evaluation of proton pump inhibitor administration in hospitalized dogs in a tertiary referral hospital.
机构信息
Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA.
Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA.
出版信息
J Vet Intern Med. 2022 Sep;36(5):1622-1627. doi: 10.1111/jvim.16491. Epub 2022 Jul 22.
BACKGROUND
Although proton pump inhibitors (PPIs) are commonly administered to hospitalized dogs, prescribing patterns and appropriateness of use require continued investigation.
HYPOTHESIS/OBJECTIVE: Describe prescription patterns and appropriateness of use associated with PPIs in hospitalized dogs at a single tertiary care facility. We hypothesized that the majority of prescriptions would not comply with current guidelines for the rational use of acid suppressants.
ANIMALS
Two hundred randomly selected hospitalized dogs.
METHODS
Retrospective evaluation of the medical records associated with a randomly selected sample of hospitalized dogs that received PPIs between January 2013 and December 2018.
RESULTS
A total of 12 610 dogs were admitted for first-time hospitalization between January 2013 and December 2018. Forty percent of these dogs (5062/12610) were prescribed a PPI PO or IV. Of the 200 randomly selected records, an adequate indication for use was identified in 27% of dogs (54/200). Of the dogs surviving to discharge, 54% (95/175) were discharged with a PPI and 51.6% (49/95) of those were prescribed an inadequate dose.
CONCLUSIONS AND IMPORTANCE
Our findings support other studies in which the majority of PPI prescriptions for hospitalized dogs at a tertiary care hospital lacked an appropriate indication. Furthermore, analysis of the prescribing patterns of dispensed PPIs identified a frequent occurrence of dosages considered inadequate, raising concern for ineffective treatment even with appropriate indications of use. With growing concern of adverse effects associated with PPI and other acid suppressant administration in human and veterinary medicine, rational use of these medications following consensus guidelines should be emphasized and treatment should be reserved for dogs with historical, physical examination, clinicopathologic, and imaging findings supportive of an appropriate indication for use.
背景
质子泵抑制剂（PPIs）常用于住院犬，但处方模式和使用的适宜性仍需进一步研究。
假设/目的：描述在一家三级保健机构住院犬中使用 PPI 的处方模式和适宜性。我们假设大多数处方不符合目前关于酸抑制剂合理使用的指南。
动物
200 只随机选择的住院犬。
方法
对 2013 年 1 月至 2018 年 12 月间接受 PPI 治疗的随机选择的住院犬的病历进行回顾性评估。
结果
2013 年 1 月至 2018 年 12 月期间，共有 12610 只犬首次住院。其中 40%（5062/12610）接受了 PPI PO 或 IV 治疗。在随机选择的 200 份记录中，54%（54/200）的犬有适当的使用指征。存活至出院的犬中，54%（95/175）出院时使用 PPI，其中 51.6%（49/95）的犬剂量不足。
结论和意义
我们的研究结果支持其他研究，即三级保健医院住院犬的大多数 PPI 处方缺乏适当的适应证。此外，对配药 PPI 的处方模式分析发现，剂量不足的情况经常发生，即使有适当的适应证，也令人担忧治疗效果不佳。鉴于人类和兽医医学中与 PPI 和其他酸抑制剂给药相关的不良反应越来越受到关注，应强调根据共识指南合理使用这些药物，并将治疗保留给具有支持适当适应证的历史、体检、临床病理和影像学发现的犬。
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