Pharmacist-Driven Stress Ulcer Prophylaxis Minimization in the Intensive Care Unit

Inclusion Criteria: * Patients ≥18 years ICU location status Exclusion Criteria: * If patient has one of the following: * Coagulopathy (defined as: platelets \< 50,000/µL, international normalized ratio(INR) \> 1.5, or partial thromboplastin time \> 2 times the control value) * Mechanical ventilation for \> 48 hours and on \< 50% goal tube feeds * Shock state on vasopressors/inotropes and on \< 50% goal tube feeds (or \< 50% of diet) * On total parenteral nutrition * Use of acid suppressive therapy prior to admission * Admission with GI bleeding * History of peptic ulcer disease * Surgery on the GI tract or cardiac surgery during the current hospital admission * Pregnancy * H. pylori infection treatment * Hypersecretory disorder (ex: Zollinger-Ellison) * Known erosive esophagitis/gastritis (not heartburn or gastroesophageal reflux disease) * Traumatic brain injury with Glasgow Coma Scale score ≤ 10 * Major burn (˃30% body surface area) * Major trauma requiring ICU admission * Spinal cord injury requiring ICU admission If patient has two or more of the following: * Administration of ˃ 100 mg daily of prednisolone (or equivalent) * Sepsis * Acute renal failure * Acute hepatic failure