Alternative dosing for PPI therapy: rationale and options.

The target goal for all acid suppressive therapy is to optimize control of intragastric pH over extended periods of time. A somewhat axiomatic paradigm has been that effective control of gastric acid production is associated with optimal outcome in acid-related diseases. The proton pump inhibitor (PPI) class of therapy has shown superiority for effective control of acid and healing of related diseases. Traditional delivery of PPIs may not be a viable option for all patients. Therefore, a clear understanding of alternative dosing formulations and related efficacies is key in order for the clinician to select the most appropriate agent and strategy to optimize outcomes and cost-effectiveness for each patient.