• Rano K Sinuraya Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, UniversitasPadjadjaran, Indonesia
  • Sharon Gondodiputro Department of Public Health, Faculty of Medicine, UniversitasPadjadjaran, Indonesia
  • Henni Djuhaeni Department of Public Health, Faculty of Medicine, UniversitasPadjadjaran, Indonesia


Objective:Stress ulcer prophylaxis is generallyadministered for the prevention stress-related mucosal disease (SRMD) in critically ill patients. Proton Pump Inhibitors (PPIs) are most commonly prescribed in preventing bleeding from SRMD. Pantoprazole iv and omeprazole iv are the most effective, but clinically effective is not always efficient. Thisstudy aimed to investigate whether the most efficient PPIs for prophylaxis in ICU settings.

Methods:An observational study was conducted on June 2014 with comparative design by using medical records in January 2012−November 2014 in a private hospital in Bandung City. Both retrospective and prospective data collection was performed in this study. Paired t-test analysis was used to compare average cost of the drugs with significant level p<0.05.

Results:The results showed average cost of pantoprazole iv 458.142 IDR/patient and omeprazole iv 575.573 IDR/patient, there were significant differences of average drug cost between pantoprazole iv and omeprazole iv (p=0.0085).

Conclusion:Both pantoprazole iv and omeprazole iv were effective but pantoprazole ivhad been found more efficient.

Keywords: Cost analysis, PPIs, Prophylaxis, Stress ulcer bleeding.


Stollman N, Metz D. Pathophysiology and prophylaxis of stress ulcer in intensive care unit patients. Journal of Critical Care. 2005;20:35-45.
2. MacLaren R, Campbell J. Cost effectiveness of histamine receptor-2 antagonist versus proton pump inhibitor for stress ulcer prophylaxis in critically ill patients. Critical Care Medicine. 2014;42(48):09-15.
3. Barletta J, Erstad B, Fortune J. Stress ulcer prophylaxis in trauma patients. . Ctitical Care. 2002;6(6):526-30.
4. AHSP. Therapeutic guidelines on stress ulcer prophylaxis. American Journal of Health System Pharmacy. 1999;56:347-79.
5. Cook D, Griffith L, Walter S, Guyatt G, Meade M, Heyland. D. The attributable mortality and length of intensive care unit stay of clinically important gastrointestinal bleeding in critically ill patients. . Critical Care Medicine. 2001;5(6):368-75.
6. Harty R, Ancha H. Stress ulcer bleeding. Current Treatment Options in Gastroenterology. 2006;9:157-66.
7. Schupp K, Schrand L, Mutnick A. A cost effectiveness analysis of stress ulcer prophylaxis. . The Annals of Pharmacotherapy. 2003;37:631-5.
8. Barkun A, Adam V, Martel M, Bardou M. Cost effectiveness analysis: stress ulcer bleeding prophylaxis with proton pump inhibitors, H2 receptor anatagonist. Value in Health. 2013;16:14-22.
9. Barletta J, Sclar D. Use of proton pump inhibitors for the provision of stress ulcer prophylaxis: clinical and economic consequences. Pharmacoeconomic. 2014;32:5-13.
10. Araujo T, Vieira S, Carvalho P. Stress ulcer prophylaxis in pediatric intensive care units. J Pediatr (Rio J). 2010;88(6):525-30.
11. Madsen K, Lorentzen K, Clausen N, Øberg E, Kirkegaard P, N NM-H. Guideline for stress ulcer prophylaxis in the intensive care unit. Danish Medical Journal. 2014;61(3):4811.
12. Quenot J, Thiery N, Barbar S. When should stress ulcer prophylaxis be used in the ICU? Curr Opin Crit Care. 2009;15(2):139-43.
13. Macdonald J, Roberts J, Washington S. Stess ulcer prophylaxis: friend or foe? Br J Hosp Med (Lond). 2012;73(4):238.
14. Rascati K. Essentials of pharmacoeconomic. Baltimore: Lippincott Williams&Wilkins; 2009.
15. Cunningham S. An introduction to economic evaluation of health care. Current Products and Practice. 2001;28(3):246-50.
16. Udeh B, Udeh C, Hata J. Cost effectiveness of stree ulcer prophylaxis: role of proton pump inhibitors. . The American Journal of Pharmacy Benefit. 2010;2(5):304-12.
17. vanHout B, Klok R, Brouwers J, Postma M. A pharmacoeconomic comparison of the efficacy and costs of pantoprazole and omeprazole for the treatment for peptic ulcer or gastroesophageal reflux disease in the Netherlands. . Clinical Therapeutics. 2003;25(2):635-46.
18. Heidelbaugh J, Goldberg K, Inadomi J. Overutilization of proton pump inhibitors: A review of cost effectiveness and risk in PPI. The American Journal of Gastroenterology. 2009;104:27-32.
19. Cahir C, Fahey T, Tilson L, Teljeur C, Bennett K. Proton pump inhibitors: potential cost reductions by applying prescribing guidelines. BMC Health Service Research. 2012;12:408.
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How to Cite
Sinuraya, R. K., S. Gondodiputro, and H. Djuhaeni. “PROTON PUMP INHIBITORS FOR STRESS ULCER BLEEDING PROPHYLAXIS IN CRITICALLY ILL PATIENTS: A COST ANALYSIS STUDY”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 10, no. 14, May 2017, pp. 128-30, doi:10.22159/ajpcr.2017.v10s2.20413.
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