Dosing of proton pump inhibitors is suboptimal among otolaryngologists treating reflux-induced upper-respiratory disease.

OBJECTIVE: To evaluate the practice of otolaryngologists treating reflux-induced upper-respiratory disease in a nationwide survey. STUDY DESIGN: Survey study using an anonymous questionnaire containing clinical vignettes. SUBJECTS AND METHODS: The survey was mailed to all 6,899 board-certified fellow members in practice in the American Academy of Otolaryngology-Head and Neck Surgery residing in the United States. RESULTS: One thousand seven hundred twenty questionnaires were returned. Respondents empirically treated reflux-induced upper-respiratory disease with proton pump inhibitors once daily and twice daily 63% and 31%, respectively. Fifteen percent did not instruct their patients on how to take the proton pump inhibitors. Of those who instructed their patients, 22% advised dosing before breakfast, 32% before breakfast and again before dinner, and 46% recommended other timings. When prescribing twice-per-day dosing, 64% responded to give before breakfast and dinner and 28% responded before breakfast and at bedtime. CONCLUSION: Suboptimal dosing of proton pump inhibitors is prevalent among otolaryngologists treating reflux-induced upper-respiratory disease.