Guidelines on optimizing the use of proton pump inhibitors: PPI stewardship

Proton pump inhibitors (PPIs) have been available for over three decades and are among the most commonly prescribed medications. They are effective in treating a variety of gastric acid-related disorders. They are freely available and based on current evidence, use of PPIs for inappropriate indications and duration appears to be common. Over the years, concerns have been raised on the safety of PPIs as they have been associated with several adverse effects. Hence, there is a need for PPI stewardship to promote the use of PPIs for appropriate indication and duration. With this objective, the Indian Society of Gastroenterology has formulated guidelines on the rational use of PPIs. The guidelines were developed using a modified Delphi process. This paper presents these guidelines in detail, including the statements, review of literature, level of evidence and recommendations. This would help the clinicians in optimizing the use of PPIs in their practice and promote PPI stewardship.

Automated summary

Proton pump inhibitors (PPIs), commonly prescribed medications for gastric acid-related disorders, have raised safety concerns due to their association with adverse effects. Inappropriate use of PPIs is common, highlighting the need for PPI stewardship to ensure their appropriate use. The Indian Society of Gastroenterology has formulated guidelines based on a modified Delphi process to promote rational use of PPIs, providing clinicians with evidence-based recommendations for optimizing their use and promoting PPI stewardship.