Background: Proton pump inhibitors (PPIs) are recognized as the most effective pharmacological agents for the inhibition of gastric acid secretion. However, the inappropriate prescription of these medications, particularly in their intravenous (IV) formulation, can lead to complications and unnecessary healthcare costs. This study aims to assess the prevalence of inappropriate IV PPI prescriptions among hospitalized patients at Khatam-al-Anbia Hospital in Shahrood.

Method: A descriptive cross-sectional study was conducted involving 343 patients aged 18 years and older who were hospitalized at Khatam Al-Anbia Hospital and received IV PPIs. Data were collected on patient demographics, dosage and administration methods, risk factors, and other pertinent clinical information using a structured checklist. The rationale for each prescription was compared against established evidence-based guidelines to determine appropriateness. In this context, "inappropriate prescription" is defined as instances where the rationale for prescribing the medication did not align with valid clinical indications.

Results: Of the 343 patients evaluated, only 234 (31.77%) instances of intravenous proton pump inhibitor (IV PPI) administration were deemed to be in alignment with established clinical guidelines and evidence-based indications. The primary reason for the observed inappropriate prescriptions was identified as stress ulcer prophylaxis, which accounted for 204 (87.17%) of the cases examined.

Conclusion: The findings of this study indicate that the majority of IV PPI prescriptions did not conform to the recommendations outlined in clinical guidelines. This underscores the necessity for further evaluations and interventions to optimize the use of PPIs in hospitalized patients.