Author Affiliations: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
We thank Barletta and El-Ibiary for their insightful comments. We wholeheartedly agree regarding the importance of attempting to identify subgroups of hospitalized, noncritically ill patients with heightened risk for nosocomial GI bleeding to determine if risk is high enough to warrant routine prophylaxis with acid-suppressive medication. Such analyses in critically ill patients were instrumental in identifying high- and low-risk subgroups of patients with numbers needed to treat of 30 and 900, respectively.1 We are currently completing such analyses in our large cohort of hospitalized, noncritically ill patients and hope to shed light on this issue in the future.
Herzig SJ, Marcantonio ER. Acid Suppressive Therapy in Noncritically Ill Patients—Reply. Arch Intern Med. 2011;171(20):1862-1864. doi:10.1001/archinternmed.2011.514