Research Letter
Less Is More
November 2017
Evaluation of a Trainee-Led Project to Reduce Inappropriate Proton Pump Inhibitor Infusion in Patients With Upper Gastrointestinal Bleeding: Skip the Drips
JAMA Intern Med. 2017;177(11):1687-1689. doi:10.1001/jamainternmed.2017.4851
Continuous infusion of proton pump inhibitors (PPIs) is recommended in patients with upper gastrointestinal bleeding (UGIB) for specific situations, such as before endoscopic identification of ulcers with high-risk features1-4 (Box). Unfortunately, PPI infusions may be continued for 72 hours without indication.2,5 Reducing the overuse of these infusions is important because, in addition to increasing the length of stay and cost, PPI overuse is associated with various complications.6 In July 2015, a fellow- and resident-led intervention was initiated with the goals of decreasing the inappropriate use of PPI infusions in patients with UGIB and promoting evidence-based care at lower costs for these patients.