Who Needs PPIs?

When people are hospitalized they are often given powerful acid suppressing drugs to prevent stress ulcers. When people are very sick and have to spend several days in a hospital bed they may develop bleeding ulcers in the digestive tract. Proton pump inhibitors such as Nexium, Prilosec or Prevacid are thought to reduce the likelihood of this complication.
A review of nearly 80,000 patient records at Beth Israel Deaconess Hospital showed that the drugs do reduce the risk of stress ulcers but the benefits may not be great enough to justify their routine use. The investigators estimate that doctors would need to treat nearly 800 patients to keep one from being harmed by a bleeding stomach ulcer. Other studies suggest that these drugs increase the risk of a patient contracting serious infections such as pneumonia or C diff, a dangerous digestive tract bacteria. Statistical comparisons suggest that these dangers may outweigh the possible benefit of acid suppressing drugs for many patients.
[Archives of Internal Medicine, Feb. 14, 2011]