Valizadeh Toosi SM, Elahi Vahed AR, Maleki I, Bari Z. Comparison of Oral versus Intravenous Proton Pump Inhibitors in Preventing Re-bleeding from Peptic Ulcer after Successful Endoscopic Therapy.
Middle East J Dig Dis 2018;
10:236-241. [PMID:
31049171 PMCID:
PMC6488504 DOI:
10.15171/mejdd.2018.116]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/18/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND
Proton pump inhibitors (PPIs) are now widely prescribed for the management of patients with acute
upper gastrointestinal bleeding; although its optimal dose and route of administration has remained a
controversial issue. The aim of this study was to assess the clinical effectiveness of high dose oral versus
intravenous (IV) PPI after successful endoscopic therapy in patients with bleeding peptic ulcer disease.
METHODS
178 patients with active upper gastrointestinal bleeding due to a peptic ulcer with stigmata
of high risk for re-bleeding entered the study. After successful endoscopic hemostasis, they were
randomized to receive either high dose oral pantoprazole (80 mg stat and 80 mg twice daily for 3
days) or high dose intravenous pantoprazole (80 mg IV infusion within 30 minutes and 8 mg per
hour for 3 days). After the 3rd day, the patients in both groups received oral pantoprazole 40 mg
twice daily for one month. The end points were comparing the rate of re-bleeding or mortality, and
the need for blood transfusion or surgery during the first month between the two groups.
RESULTS
There were not significant statistical differences between the two groups in the volume of
blood transfusion, mean duration of hospital stay, need to surgery, or mortality rates. However, the
rates of re-bleeding were 2.3% (2:88) in the IV group and 3.3% (3:90) in the oral group (p = 0.6).
CONCLUSION
According to our findings, it seems that high dose oral PPI can be a good alternative to high
dose IV PPI in patients with bleeding peptic ulcer who are at high risk of re-bleeding. Due to the
lower cost and the availability of oral PPIs, their use can be economically much more affordable.
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