Use of proton pump inhibitors in general practice

Table 1 Rules of the Italian Drug Agency for the refund of proton pump inhibitor drugs

The prescription of PPI refundable by the National Health Service is limited to
The prevention of serious complications of the upper gastrointestinal tract in patients in chronic treatment with NSAIDS or in antiaggregant therapy with low doses of ASA, provided there is one of the following conditions of risk: (1) history of past digestive hemorrhage or peptic ulcer not healed with Helicobacter pylori treatment; (2) concomitant therapy with anticoagulants or cortisone; and (3) advanced age
Duration of treatment 4 wk (occasionally 6 wk): Duodenal or gastric ulcer, in association with drugs eradicating the infection; GERD with or without esophagitis (first episode)
Duration of treatment extended to reevaluate after one year: Zollinger-Ellison syndrome; relapsing duodenal or gastric ulcer; GERD with and without esophagitis (relapsing)

PPI: Proton pump inhibitor; GERD: Gastroesophageal reflux disease; ASA: Acetylsalicylic acid; NSAIDS: Non-steroidal ant-inflammatory drugs.