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Endoscopic therapy and proton-pump inhibitor (PPI) therapy are typically used together to treat bleeding peptic ulcers and high-risk endoscopic stigmata for rebleeding. However, the optimal dose of PPI therapy in this setting is not known.
In a randomized, double-blinded study performed in 11 Italian treatment centers, investigators compared high-dose (80-mg bolus, followed by an infusion of 8 mg per hour for 72 hours) with low-dose (40-mg bolus daily for 72 hours) PPI therapy — the PPI could be either omeprazole or pantoprazole — in patients who had actively bleeding peptic ulcers or nonbleeding ulcers with visible vessels or adherent clots. All patients were treated endoscopically with epinephrine injection or thermal therapy. Initial PPI …