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Licensed Unlicensed Requires Authentication Published by De Gruyter January 11, 2020

Analysis of the use and cost of stress ulcer prophylaxis for surgical inpatients

  • Dhani Wijaya , Elfri Padolo , Chrismawan Ardianto , Sumarno , Fendy Matulatan , Chris Alderman and Suharjono EMAIL logo



Stress ulcer is a superficial and asymptomatic lesion and causes bleeding. As many as 50% of death cases are reported as the result of stress ulcer bleeding. Stress ulcer prophylaxis (SUP) is a drug used to prevent gastrointestinal tract injuries due to stress ulcers. The inappropriate use of SUP drugs can cause adverse drug reactions, and thus SUP drugs are only given to patients in accordance with guidelines in order to avoid the overuse of SUP drugs. The aim of this present study is to analyse the suitability of SUP drug usage based on the criteria from the American Society of Health-System Pharmacists (ASHP) and the drug costs of SUP overuse.


An observational descriptive study was conducted from April 24, 2019, to May 17, 2019, in the inpatient surgical ward of Dr. Soetomo General Hospital. Data were obtained from patient medical health records.


One hundred fifty-two patients used 1404 SUP drugs. Approximately 48% of usage did not suit the ASHP criteria and was considered as medication overuse. The cost of excessive SUP usage during the study period was more than US $65, which is 30.08% of the total drug cost of prescribed stress ulcer drugs.


The present study suggests that the relatively high excessive drug costs for SUP show a need for monitoring of the application of SUP therapy guidelines.


Gratitude is due to the director and the head of the Inpatient Operating Room of Dr. Soetomo General Hospital.

  1. Research funding: We thank to Tahir Foundation professorship program (Dr. Suharjono) for supporting the study.

  2. Author contributions: All authors have accepted responsibility for the entire content of the manuscript and approved its submission.

  3. Competing interests: The authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: This study was designed to comply the criteria for ethical conduct and was approved by the Health Research Ethics Committee of Dr. Soetomo General Hospital, with reference number 1121/KEPK/IV/2019.


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Received: 2019-10-15
Accepted: 2019-11-20
Published Online: 2020-01-11

© 2019 Walter de Gruyter GmbH, Berlin/Boston

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