Author Affiliations: Department of Pharmacy Practice, Midwestern University, College of Pharmacy, Glendale, Arizona.
We read with great interest the article by Herzig et al1 describing acid-suppressive therapy and the risk for nosocomial gastrointestinal tract (GI) bleeding. The authors have reported the incidence of clinically significant bleeding (which we believe is the most relevant end point) to be extremely low (0.22%), resulting in a number needed to treat to prevent 1 episode of bleeding of 834. This study validates previous statements that acid-suppressive therapy should not routinely be administered to noncritically ill patients or patients who lack major risk factors for stress-related clinically significant bleeding.2
Barletta JF, El-Ibiary SY. Acid Suppressive Therapy in Noncritically Ill Patients. Arch Intern Med. 2011;171(20):1862–1864. doi:10.1001/archinternmed.2011.513