We thank Drs Lin and Tsai for their interest in and comments on our article.1 We concur with their suspicion that clinicians may have tended to use pantoprazole in sicker patients, but as we point out in the article, acuity has not specifically been identified as a risk factor for upper gastrointestinal bleeding in critically ill patients. Also, despite the higher acuity scores among the patients receiving pantoprazole, with the exception of the incidence of upper gastrointestinal bleeding, the outcome parameters did not differ, calling into question the clinical significance of the difference in the Acute Physiology and Chronic Health Evaluation II scores between the 2 groups.1,–3 

With regard to the dosing of pantoprazole, the prophylaxis regimens used at our institution are similar to those used elsewhere, and do not target gastric pH. Also, the dosing of pantoprazole was consistent with the dosing of PPIs...

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