553Cases Of Acid Related Disease In Patients With The Use Of Proton Pump Inhibitors Rationality Analysis

Objective:To analyze the rationality of proton pump inhibitor treatment for acid-related disease; to demonstrate the irrational uses of proton pump inhibitors and the contributing factors to provide references for rational clinical use of these drugs in the future.Methods:1. A retrospective survey was made. Case histories of patients hospitalized at our hospital that were diagnosed as "acid-related disease"(Gastric ulcer, duodenal ulcer, Zollinger-Ellison syndrome, reflux esophagitis, stress ulcer) from01/01/2009to12/31/2011and that were treated with proton inhibitor for at least one time were statistically analyzed.2. Using the SPSS-19software, a univariate non-conditional logistic regression was made for the contributing factors to irrational use of proton pump inhibitors and further multivariate non-conditional logistic regression was made using the backward method.Results:1. Five hundred and fifty-three cases of proton pump inhibitor usage for acid-related diseases were enrolled.383were male (69.26%) and170female (30.74%), their ages span from2to89with an average of49.15.2. Of the proton pump inhibitors for acid-related disease, pantoprazole for injection was most frequently used (413/553,74.68%), and it’s usually combined with antibiotics, gastric mucosal protective agents and other proton pump inhibitors.3. For347of the553cases (62.75%), the use of proton pump inhibitors was considered rational. Among the206cases of irrational use of these drugs,121were considered due to improper indicators (121/553,21.88%). According to a proper indicator,432cases were treated with proton pump inhibitors but17.36%of them still fail to use these drugs properly:improper course of treatment-3.46%, improper solvent dose-2.78%, improper daily frequency-2.31%, and improper single dosage1.16%.4. Multivariate non-conditional logistic regression showed irrational use of proton pump inhibitors has a positive correlation with endoscopy (rate of irrational use for patient without an endoscopy is2.036fold that of those with one) and a negative correlation with ICU, age, NSAIDs usage and improper indicators, that is, absence of endoscopy, young age, ICU, combination of NSAIDs all contribute to higher rate of irrational use of proton pump inhibitors.Conclusion:1. Among the553cases of acid-related disease, some used proton pump inhibitors irrationally, for improper indictors or by improper combination therapy, course of treatment, solvent dose, daily frequency, and singe dosage.2. Absence of endoscopy, young age, ICU, combination of NSAIDs all contribute to higher rate of irrational use of proton pump inhibitors.3. For long term use of proton pump inhibitor, regular liver-kidney function and electrolytes check are recommended.