Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

PPIs over-prescribed

An editorial in the British Medical Journal has suggested that proton pump inhibitors (PPIs) are over-prescribed.

The authors note that £425 million was spent on PPIs in England in 2006. They also note that studies have indicated that between 25% and 70% of patients taking these drugs have no appropriate indication and as such a minimum of £100 million was spent unnecessarily on these drugs.

They suggest that effective and less expensive alternatives like ranitidine are a suitable option for many patients. Finally, increasing prevalence of pneumonia and Campylobacter enteritis and increased risk of infection with Clostridium difficile are highlighted as rare but problematic side effects.

Action: Clinicians should ensure that they follow the dyspepsia guidelines produced by the National Institute of Health and Clinical Excellence.

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