Intermittent versus continuous pantoprazole infusion in peptic ulcer bleeding: a prospective randomized study.
OBJECTIVE
Rebleeding has remained the most important determinant of poor prognosis in peptic ulcer bleeding. Gastric acid plays an important role in the pathogenesis of rebleeding. We aimed to compare the efficiency of intermittent and continuous pantoprazole infusion treatment on peptic ulcer rebleeding after endoscopic therapy.


METHODS
In this prospective study, patients with active peptic ulcer bleeding or non-bleeding visible vessel were treated initially with endoscopic therapy. They were randomized to receive intermittent or continuous intravenous pantoprazole treatment. Rebleeding rate, duration of hospital stay, need for total blood transfusion and need for urgent surgery were compared among both groups.


RESULTS
Rebleeding rate (6.1 vs. 8.3%), duration of hospital stay (4.17 vs. 4.41), need for total blood transfusion (2.18 vs. 2.59) and need for urgent surgery (4.1 vs. 4.2%) were similar in intermittent and continuous pantoprazole infusion therapy groups, respectively. There was no bleeding-related death in either group.


CONCLUSIONS
In patients with peptic ulcer bleeding, intermittent and continuous pantoprazole infusion after successful endoscopic therapy have comparable outcomes in reducing rebleeding. Both have similar effects on hospital stay, need for blood transfusion and urgent surgery. Intermittent administration has application and cost advantages over continuous infusion.
Yüksel
Ilhami
I
Department of Gastroenterology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey. yukselilhami@hotmail.com
Ataseven
Hilmi
H
Köklü
Seyfettin
S
Ertuğrul
Ibrahim
I
Başar
Omer
O
Odemiş
Bülent
B
Ibiş
Mehmet
M
Saşmaz
Nurgül
N
Sahin
Burhan
B
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D004381:Duodenal Ulcer / Q000188:drug therapy*; D016099:Endoscopy, Gastrointestinal; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D000077402:Pantoprazole; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy*; D011446:Prospective Studies; D012008:Recurrence; D013276:Stomach Ulcer / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D000077402:Pantoprazole