Author Interviews, Critical Care - Intensive Care - ICUs, Gastrointestinal Disease, JAMA / 17.01.2020 Interview with: Dr. Paul Young MBChB, BSc (Hons), FCICM Medical Director of the Wakefield Hospital ICU Head of the Intensive Care Research Unit Wellington Hospital 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. (more…)