Evaluation of Stress Ulcer Prophylaxis Guideline in the Intensive Care Units of a Teaching Hospital: A Cross Sectional Study

Abstract

Background: One of the complications of critical ill patients admitted to intensive care unit (ICU) are stress-related mucosal damage. Stress ulcer prophylaxis (SUP) should be administered to all critically ill patients with at least one major risk factor and two or more minor criteria.

Methods: This study was performed during 6 months from October 2013 to December 2013 in Namazi Hospital intensive care units to assess the appropriate administration of SUP, according to American Society of Health-System Pharmacists (ASHP) protocol. Candidate for SUP according the ASHP guideline is considered if there is a at least one major risk factor or two or more minor risk factors.

Results: Ninety-four patients were enrolled (46 men and 48 women). The mean age of study subjects was 51.5 years. The most major risk factor to stress ulcer found to be mechanical ventilation more than 48 hours (53%). The most minor risk factor for stress ulcer was ICU admission for less than one week (23.5%). Most prescribed medication for stress ulcer prophylaxis was intravenous Pantoprazole (44.7%). Our results have shown that about 74% patients were candidate for SUP according the ASHP guideline. 13(13.8%) of patients had only major risk factors. 5 (5.3%) of patients received SUP while they did not have at least one major risk factor or two or more minor risk factors.

Conclusion: Our results have shown that 76.2% of the total SUP administrations were compliant with the ASHP guideline. Among the prescribed medication for SUP, intravenous pantoprazole had the highest percentage of administration (44.7%) and oral omeprazole had the lowest percentage of administration (7.4%). According to the results of our study, 72% of the route administrations are compliant with the ASHP guideline.