PPI Use

https://www.ncbi.nlm.nih.gov/pubmed/25730198?log$=activity


As I have participated in clinicals over the past two semesters, I have noticed that the majority of patients I have taken care of were prescribed a proton pump inhibitor daily for GI prophylaxis to prevent stress ulcers. PPIs work by stopping the final step of acid production in the stomach. While this is effective in prevention of gastric ulcers, it increases the risk of bacterial growth because the PPI causes the gastric secretions to be more alkaline. C. Diff is one of the major bacterial infections in hospitalized patients and using a PPI with patients with c. Diff leads to a higher occurrence of reinfection. In the above study, 754 patients with an initial episode of health care associated c. Diff infections were evaluated to determine if PPI use was associated with c. Diff infection recurrence. Quiz Ref IDRecurrence was common, occurring in 193 of 754 patients (25.6%) within 90 days. The article also states that possibly preventing recurring c. Diff infections could end with stopping the over prescribing of PPIs. It also states that PPIs are potentially unnecessary and over prescribed. I believe that PPI prophylaxis is easier than having a patient develop a gastric ulcer and then having to also treat that on top of the primary diagnosis. PPI use should be carefully considered when dealing with the care of patients with higher risk for infections and those with previous c. Diff infections.