Even without differences in efficacy or safety between PPIs, costs can vary x 10. The cheapest in BC? Pantoprazole Mg 40mg or Rabeprazole 10mg. Most expensive: Dexlanzoprazole
Cdn Association of Gastroenterology (CAG), Choosing Wisely & Cdn Deprescribing Network: PPI therapy for GI symptoms "should not be maintained long term without an attempt to stop/reduce" at least once/year in most pts
In 2019, we noted that “In many clinical settings, we do not know whether the benefits of long-term PPI use outweigh the harms,” and that “patients on long-term PPI therapy should be reassessed.”
We identified 100+ systematic reviews published in last 5 yrs of "specific harms associated with long-term PPI use" + "observational studies have identified signals of serious harms from long-term PPI" use
1⃣ A drug is prescribed 💊
2⃣ #AdverseEvent occurs but is misinterpreted as a new medical condition ⚠️
3⃣Another drug is prescribed for the drug-induced adverse event 💊💊
✅Fewer than 2% of urine cultures meaningfully impact choice of treatment or need for follow-up
✅Most guidelines recommend against culture for
symptomatic uncomplicated #UTIs