Author Interviews, Critical Care - Intensive Care - ICUs, Gastrointestinal Disease, JAMA / 17.01.2020
Risks and Benefits of Proton Pump Inhibitors To Prevent GI Bleeds in Intensive Care Patients
MedicalResearch.com Interview with:
[caption id="attachment_52838" align="alignleft" width="100"] Dr. Paul Young[/caption]
Dr. Paul Young MBChB, BSc (Hons), FCICM
Medical Director of the Wakefield Hospital ICU
Head of the Intensive Care Research Unit
Wellington Hospital
MedicalResearch.com: What is the background for this study?
Response: Proton pump inhibitors (PPIs) are among the most widely prescribed drugs in the intensive care unit (ICU) in the world. Many, if not most, prescriptions of PPIs in the ICU are for stress ulcer prophylaxis. Although PPIs are used most widely for this indication, histamine-2 receptor blockers (H2RBs) are used in preference to PPIs in some ICUs. This practice variation, which appears to be largely dependent on clinician preference rather than based on patient-specific factors, has continued for decades. The PPIs vs. H2RBs for Ulcer Prophylaxis Therapy in the Intensive Care Unit (PEPTIC) trial results raise the possibility that PPIs, the most commonly used medicines for stress ulcer prophylaxis, may be responsible for a clinically important increase in the risk of death that, in global health terms could equate to many tens of 1000s of deaths per year.
Dr. Paul Young[/caption]
Dr. Paul Young MBChB, BSc (Hons), FCICM
Medical Director of the Wakefield Hospital ICU
Head of the Intensive Care Research Unit
Wellington Hospital
MedicalResearch.com: What is the background for this study?
Response: Proton pump inhibitors (PPIs) are among the most widely prescribed drugs in the intensive care unit (ICU) in the world. Many, if not most, prescriptions of PPIs in the ICU are for stress ulcer prophylaxis. Although PPIs are used most widely for this indication, histamine-2 receptor blockers (H2RBs) are used in preference to PPIs in some ICUs. This practice variation, which appears to be largely dependent on clinician preference rather than based on patient-specific factors, has continued for decades. The PPIs vs. H2RBs for Ulcer Prophylaxis Therapy in the Intensive Care Unit (PEPTIC) trial results raise the possibility that PPIs, the most commonly used medicines for stress ulcer prophylaxis, may be responsible for a clinically important increase in the risk of death that, in global health terms could equate to many tens of 1000s of deaths per year.
Dr. Diaz[/caption]
Lucia Diaz, M.D., is chief of pediatric dermatology, dermatology residency associate program director and assistant professor of medicine and pediatrics at Dell Medical School. She is also co-director of the dermatology-rheumatology combined clinic at Dell Children’s Medical Center.
[caption id="attachment_52796" align="alignleft" width="150"]
Dr. Jaquez[/caption]
Sasha Jaquez, Ph.D. is a pediatric psychologist at Dell Children's Medical School/Dell Children's Medical Center and specializes in seeing children with chronic medical illness, including skin disorders.
[caption id="attachment_52791" align="alignleft" width="294"]
Dr. Breyer[/caption]
Benjamin N. Breyer MD, MAS, FACS
Associate Professor
Departments of Urology and Epidemiology and Biostatistics
University of California, San Francisco
Vice-Chair of Urology
Chief of Urology, Zuckerberg San Francisco General Hospital and Trauma Center
Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship
MedicalResearch.com: What is the background for this study?
Response: There has been a large increase in upright scooter usage among adults as a mode of transportation. It's convenient for commuters and may encourage greater use of public transit leading to less car traffic in cities.
Dr. Marra[/caption]
Alexandre R. Marra, MD PhD
Iowa Infection Prevention Research Group
University of Iowa Carver College of Medicine
Division of Medical Practice, Hospital Israelita Albert Einstein
São Paulo, Brazil
MedicalResearch.com: What is the background for this study?
Response: This is a comprehensive systematic literature review evaluating the burden of C. difficile infections in the U.S healthcare system. The literature has diverse studies with variable outcomes. Thus, we only included incidence estimates derived from multicenter studies. In our meta-analysis to calculate incidence, data were pooled only with denominators using the same unit (patient-days) to avoid comparisons with different denominators. For length of stay (LOS), we only included studies that used advanced statistical methods (e.g., propensity score matching).
