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Introduction An article published by the British Society of Gastroenterology suggested that the use of Sucralfate may be beneficial in patients with non-variceal upper GI inflammation despite PPI therapy. Further articles describe the limited evidence supporting the use of Sucralfate in functional dyspepsia. Sucralfate is listed as ‘hospital only’ medication in many primary care settings and therefore repeat prescriptions often remain with secondary care teams, incurring significant costs; In our medium sized district general hospital, a cost of over £260,000 per annum. Suspension formulations were documented to be ten times the cost of tablet formulations. An evaluation of spending was undertaken to consider whether the prescribing of Sucralfate aligns with the national recommendations and whether it is providing therapeutic benefits to our patients.Methods A review of all patients (94) in the calendar year of 2024 who had received one or more hospital pharmacy issued prescriptions of Sucralfate. Exclusion criteria: Under age of 18 years, deceased patients, patients only requesting a single prescription, patients with insufficient data available on electronic patient records. Data recorded: Demographics, where Sucralfate was initiated, compliance of prescription to BSG guidance, trial of PPI prior to initiation, evidence of OGD prior to initiation, evidence of follow up, documentation of endoscopic changes and documentation of symptom change, efficacy of suspension vs tablet formulations.Results 84% of prescriptions met indications derived from BSG guidance, 95% of patients underwent at least one OGD prior to commencing Sucralfate; of these patients, 93% had at least one OGD following a trial of PPI. 92% of patients trialled a PPI prior to commencing Sucralfate. 85% had evidence of documented follow up available to view on electronic patient record system. 57% of patients had documentation on whether Sucralfate had changed endoscopic appearances, of which, 71% of patients had an improvement in endoscopic changes. Of these patients, 77% of patients taking the suspension had endoscopic improvement vs 56% taking tablets. 59% of patients had documentation on whether Sucralfate had any change in their symptoms of which, 64% of patients had an improvement in symptoms. Of these patients, 62% of patients taking the suspension had symptomatic improvement vs 67% of patients taking tablets.Conclusion The majority of patients at our district general hospital receiving Sucralfate, both suspension and tablet formulations, met the indications derived from BSG guidance and received an OGD prior to initiation. Sucralfate has shown to have a positive effect on patient’s endoscopic findings as well as improving symptoms