[Use and abuse histamine H2 receptor blockers in hospitalized patients]. / Uso y abuso de los bloqueadores de los receptores H2 de la histamina en pacientes hospitalizados.

ABSTRACT

OBJECTIVE: To evaluate if the histamine H2 blockers (H2B) are adequately prescribed in hospitalized patients outside intensive care units. BACKGROUND: H2B are frequently prescribed. However their good tolerance and easy access have contributed to misuse them. METHODS: Six hundred and seventy eighth hospitalized patients from three different Mexican institutions were included in a prospective study, 100 patients from each hospital who were taking H2B were selected. We investigated the indication for prescribing them as well as the type, dose and adverse effects, international recommendations were taken into account to assess if the treatment was correctly prescribed. RESULTS: Two hundred twenty seven patients (76%) received H2B for prophylactic reasons, however a clear justification for their use was found in only 79 of the cases (35%). H2B were prescribed to treat peptic ulcer disease or upper gastrointestinal bleeding in 17 patients (6%). Two out of three patients received more than 10 doses of H2B, being ranitidine the most frequently prescribed. CONCLUSIONS: Although H2B have a low rate of adverse reactions, their use in hospitalized patients should be rigorously controlled. In fact, the majority of our patients did not need them. Thus, their routine use should be proscribed to avoid unnecessary costs.