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01-05-2015 | Editorial

Primum non nocere and challenging conventional treatment

Authors: Adam M. Deane, Gordon H. Guyatt

Published in: Intensive Care Medicine | Issue 5/2015

Excerpt

If you knew that, for every 80 patients to whom you prescribed an acid-suppressive drug, 1 patient would develop a ventilator-associated pneumonia, and that, for every 100 patients to whom you prescribed these drugs, 1 patient would develop a Clostridium difficile infection, would you continue to prescribe these drugs? What if you knew that you needed to prescribe acid-suppressive drugs to more than 100 patients to prevent 1 patient from having a diagnostic endoscopy? …

Krag M, Perner A, Wetterslev J, Wise MP, Borthwick M, Bendel S, McArthur C, Cook DJ, Nielsen N, Pelosi P et al (2015) Prevalence and outcome of gastrointestinal bleeding and use of acid suppressants in acutely ill adult intensive care patients. Intensive Care Med. doi:10.1007/s00134-015-3725-1 PubMed

Barletta JF, Sclar DA (2014) Proton pump inhibitors increase the risk for hospital-acquired Clostridium difficile infection in critically ill patients. Crit Care 18(6):714CrossRefPubMedCentralPubMed

Plummer MP, Blaser AR, Deane AM (2014) Stress ulceration: prevalence, pathology and association with adverse outcomes. Crit Care 18(2):213CrossRefPubMedCentralPubMed

Cook DJ, Fuller HD, Guyatt GH, Marshall JC, Leasa D, Hall R, Winton TL, Rutledge F, Todd TJ, Roy P et al (1994) Risk factors for gastrointestinal bleeding in critically ill patients. Canadian Critical Care Trials Group. N Engl J Med 330(6):377–381CrossRefPubMed

Cook D, Guyatt G, Marshall J, Leasa D, Fuller H, Hall R, Peters S, Rutledge F, Griffith L, McLellan A et al (1998) A comparison of sucralfate and ranitidine for the prevention of upper gastrointestinal bleeding in patients requiring mechanical ventilation. Canadian Critical Care Trials Group. N Engl J Med 338(12):791–797CrossRefPubMed

Krag M, Perner A, Wetterslev J, Wise MP, Hylander Moller M (2014) Stress ulcer prophylaxis versus placebo or no prophylaxis in critically ill patients. A systematic review of randomised clinical trials with meta-analysis and trial sequential analysis. Intensive Care Med 40(1):11–22CrossRefPubMed

MacLaren R, Reynolds PM, Allen RR (2014) Histamine-2 receptor antagonists vs proton pump inhibitors on gastrointestinal tract hemorrhage and infectious complications in the intensive care unit. JAMA Intern Med 174(4):564–574CrossRefPubMed

Buendgens L, Bruensing J, Matthes M, Duckers H, Luedde T, Trautwein C, Tacke F, Koch A (2014) Administration of proton pump inhibitors in critically ill medical patients is associated with increased risk of developing Clostridium difficile-associated diarrhea. J Crit Care 29(4):e611–e695CrossRef

Marik PE, Vasu T, Hirani A, Pachinburavan M (2010) Stress ulcer prophylaxis in the new millennium: a systematic review and meta-analysis. Crit Care Med 38(11):2222–2228CrossRefPubMed

10.

Nair GB, Niederman MS (2015) Ventilator-associated pneumonia: present understanding and ongoing debates. Intensive Care Med 41(1):34–48CrossRefPubMed

11.

Dubberke ER, Olsen MA (2012) Burden of Clostridium difficile on the healthcare system. Clin Infect Dis 55(Suppl 2):S88–S92CrossRefPubMedCentralPubMed

12.

Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R et al (2013) Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 39(2):165–228CrossRefPubMed

13.

Eastwood GM, Litton E, Bellomo R, Bailey MJ, Festa M, Beasley RW, Young PJ (2014) Opinions and practice of stress ulcer prophylaxis in Australian and New Zealand intensive care units. Crit Care Resusc 16(3):170–174PubMed

14.

Barletta JF, Sclar DA (2014) Use of proton pump inhibitors for the provision of stress ulcer prophylaxis: clinical and economic consequences. Pharmacoeconomics 32(1):5–13CrossRefPubMed

15.

Mulla SM, Scott IA, Jackevicius CA, You JJ, Guyatt GH (2012) How to use a noninferiority trial: users’ guides to the medical literature. JAMA 308(24):2605–2611CrossRefPubMed

Title: Primum non nocere and challenging conventional treatment
Authors: Adam M. Deane
Gordon H. Guyatt
Publication date: 01-05-2015
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 5/2015
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-015-3785-2

Keynote webinar | Spotlight on medication adherence

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Primum non nocere and challenging conventional treatment

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Keynote webinar | Spotlight on medication adherence

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