Evaluation of appropriateness of intravenous pantoprazole in inpatients of Tertiary Care Hospital

Proton pump inhibitors are currently the most effective agents for acid related disorders. Pantoprazole is a frequently used proton pump inhibitor in healthcare practice. To evaluate the usage pattern of intravenous pantoprazole and to assess its appropriateness in accordance with the guidelines and criteria in terms of indication for use, dose and duration of therapy. Methodology: The study was conducted in 141 patients admitted in Sagar hospital, Bengaluru. It was a prospective, observational study for six months. Prescriptions were evaluated for appropriate use of IV Pantoprazole. Results: Out of 141 patients, 32(22.7%) patients were had UGIB and 109(77.30%) patients were Non-UGIB patients. 36.87% of IV Pantoprazole prescriptions were inappropriate either in terms of dose, duration and indication for use. Only 37.58% of the patients with IV pantoprazole therapy were on NPO (Nil PerOs). We observed that all 32 UGIB patients who had clinical signs of gastrointestinal bleeding underwent endoscopy. But endoscopy was not performed in most of the Non-UGIB cases (69/109). Among 72 patients who underwent endoscopy, (45/72), 62.50% patients received IV Pantoprazole prior to endoscopy. Majority (90%) of patients received 40 mg IV pantoprazole twice daily. Conclusion: Institutional guidelines were developed to promote appropriate use of the IV proton pump inhibitor pantoprazole. Inappropriate and unsupervised use of IV pantoprazole can lead to unwanted consequences such as hypersensitivity reactions and prolonged durations of treatment and increased treatment cost. This study suggests that the majority of IV PPI prescriptions were appropriate. But still more satisfactory results can be achieved through adherence of the guidelines.