Evaluation of Proper Prescription of Antacid Agents in a Group of Critically Ill Children Admitted to PICU in 2018-2019

Critically ill patients, especially those requiring admission to intensive care units (ICU), are at risk for stress-related gastrointestinal mucosal damage. We aimed to evaluate the frequency of proper prescription of antacid agents in a group of critically ill children admitted to PICU.
In this retrospective study, the medical records of children aged between 1 month and 15 years who were admitted in 2018-2019 to the PICU of Imam Hossein children's hospital, Isfahan, Iran, were reviewed. Demographic data, indications for PICU admission, principal diagnosis, the severity of the disease, incidence of bleeding during hospitalization, indications for stress ulcer prophylaxis, prescription of the antacid agents, type of antacid prescribed, and the patient's final outcome were recorded. All the data were gathered and organized by a medical intern. We calculated the rate of the patients who were indicated for SUP, those who were not indicated for SUP (Stress Ulcer Prophylaxis), those who received SUP (Stress Ulcer Prophylaxis), and those who did not receive SUP. Data analysis was performed with the Statistical Package for the Social Sciences software (SPSS, version 24.0, IBM, Armonk, New York).
We found that 204 (92.7%) of our patients received antacid agents for gastric SUP. Among the patients receiving SUP, 198 (90%) had an indication for SUP, and only 6 (2.7%) cases received unnecessary prophylaxis? In addition, 16 (7.2%) patients had no indication of receiving SUP and did not receive any prophylaxis. We also reviewed the type of antacid medication that was prescribed for SUP and found that 157 (72%) patients had received PPI, and 57 (30%) had received H2Ras.
The findings of the current study revealed that almost all of our study population who had an indication for prophylaxis of stress ulcer appropriately received antacid agents. We suggest that there is a crucial need to conduct large prospective and multicentric studies in pediatric centers to prepare a universally accepted guideline for the prophylaxis of stress ulcers in the pediatric age group.