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Drug Utilization Research / Quality use of medicines (including indicators and guidelines)

Poster Session A

(A-137) Prevalence and prescribing patterns of stress ulcer prophylaxis pharmacotherapy in China: A multi-center, prospective study

Sunday, August 24, 2025
12:00 PM - 1:30 PM ET

    Presenting Author(s)

  • HL

    Hailong Li

    1. Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University; Children's Medicine Key Laboratory of Sichuan Province 2. NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation 3. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, China (People's Republic)

    • Co-Author(s)

  • LZ

    Lingli Zhang

    1. Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University; Children's Medicine Key Laboratory of Sichuan Province 2. NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation 3. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education 4. West China Biomedical Big Data Center, West China Hospital, Sichuan University 5. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, China (People's Republic)

  • LZ

    Linan Zeng

    1. Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University; Children's Medicine Key Laboratory of Sichuan Province 2. NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation 3. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education 4. West China Biomedical Big Data Center, West China Hospital, Sichuan University, China (People's Republic)

Background: ICU patients face risks of GIB, yet SUP is widely used despite limited evidence. Chinese guidelines may cause overuse.

Objectives: To describe the current prescribing patterns for pharmacotherapy for stress ulcer prophylaxis (SUP) among adult patients in ICUs in China and their consistency with current recommendations.

Methods: This multicenter prospective cross-sectional study reviewed medical records of adult ICU patients newly admitted to ICUs and receiving SUP for stress-related gastrointestinal bleeding (GIB). ICU patients were classified into four risk groups: very high-, high-, moderate-, and low-risk. The proportion of patients receiving SUP was determined at each hospital. The combined prevalence from independent hospitals was assessed via mixed-effect models.

Results: Of the 3134 enrolled patients, the prevalence of SUP use for very high-, high-, moderate-, and low-risk patients in ICUs was 75.9%, 74·3%, 69·8%, and 67·4%, respectively. For patients transferred to the general ward, the prevalence of SUP use was 42·8%. Most patients (95·9%) received proton pump inhibitors. The median duration of SUP use was 3.0 days. The most common route of administration was intravenous administration (86·8%); of these, 29·0% also simultaneously received enteral nutrition.

Conclusions: The prevalence of SUP use was very high in all ICUs in China without marked variations across risk groups. SUP use may be overused in patients at moderate or low risk of stress-related GIB. Consistent with BMJ recommendations, most Chinese physicians select proton pump inhibitors for SUP; however, oral rather than intravenous administration could be helpful.