The high efficacy and low toxicity of proton pump inhibitors (PPIs) has contributed to their frequent prescription worldwide, often without clear indication.

Such widespread over-prescription incurs avoidable financial and clinical costs1. PPI use is associated with a number of adverse consequences including Clostridium difficile infection, community acquired pneumonia, osteoporosis, hypomagnesaemia and kidney injury2-7.

In light of this, PPI prescription should be reserved for patients where there is a clear indication and clinicians should consider stopping PPIs when the indication is unclear. There are data to support stopping PPIs in patients who have been taking them long term.