Although licensed and frequently used for stress ulcer prophylaxis, overwhelming supportive evidence is scanty. Enteral nutrition and gastric acid blockers have been shown to be as effective.

Evidence for a reduced incidence of nosocomial pneumonia compared to H2 blocker therapy is also conflicting. Significant reduction in nosocomial pneumonia has been shown compared to a combination of H2 blocker plus antacid but not against H2 blocker alone. Indeed, a large multicentre RCT comparing ranitidine with sucralfate showed no difference in pneumonia rate and a lower incidence of GI bleeding with ranitidine.

Antacids should not be given for 30min before or after sucralfate.


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