ICU patients assigned to proton-pump inhibitors (PPIs) versus histamine-2 receptor blockers (H2RBs) for ulcer prophylaxis had marginally higher 90-day mortality that just missed statistical significance. Significantly fewer UGIB events occurred among those assigned to PPIs compared to H2RBs.

In a crossover study design, 50 ICUs adopted 6-month preferential use of PPIs versus H2RBs, followed by 6 months of the alternate therapy.

Among 26,828 patients who enrolled and participated, mortality rates differed only modestly between patients randomized to PPIs versus H2RBs.

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