title: Are higher doses of proton pump inhibitors better in acute peptic bleeding?
abstract: Although there is broad consensus about the benefits of proton pump inhibitors in acute upper peptic bleeding, there is still controversy over their optimal dosing. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified six systematic reviews including 27 randomized trials addressing this question. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded high-dose proton pump inhibitors probably result in little or no difference in re-bleeding rate or mortality. The risk/benefit and cost/benefit balance probably favor use of low-doses.
authors.affiliation: Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile. Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro, Chile. Email: radagabriel@gmail.com.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Villalón
authors.affiliation: Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.
authors.forename: Roberto
authors.initials: R
authors.lastname: Olmos
authors.affiliation: Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile; Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; GRADE working group; The Cochrane Collaboration.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rada
mesh_terms: D000208:Acute Disease; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D006801:Humans; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy* / Q000473:pathology; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence
chemical_list: D054328:Proton Pump Inhibitors