Q: Stress ulcer prophylaxis in ICU should be use with caution with proper indications. Blanket use of stress ulcer prophylaxis in all ICU patients may increase the risk of

A) Nosocomial pneumonia 
B) Clostridium difficile infection
C) Drug interactions
D) Thrombocytopenia 
E) All of the above


Answer: E

Objective of above question is to highlight proper use of stress ulcer prophylaxis in ICUs. With overuse of protocols and check-lists there is always a danger of overuse of stress ulcer prophylaxis. Major indications of stress ulcer prophylaxis are

•  Coagulopathy, 
•  Mechanical ventilation for  more than 48 hours
• History of GI bleed in last 12 months
• Traumatic brain injury
•  traumatic spinal cord injury
•  burn injury
•  severe sepsis
• high steroid treatment

Every patient should be prioritize on case to case basis instead of blanket order set.