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Proton-pump inhibitor (PPI) treatment can reduce rebleeding and mortality rates in patients with bleeding peptic ulcers and endoscopic stigmata for rebleeding. This effect is seen with and without endoscopic hemostasis. Although most treatment guidelines recommend a high-dose intravenous PPI regimen for the first 3 days, the optimal PPI dose has not been determined.
To explore this issue, investigators in Taiwan conducted a clinical trial involving patients with high-risk bleeding ulcers in whom endoscopic hemostasis using epinephrine injection and thermocoagulation was successful. The 201 participants were randomized to receive either high-dose (80-mg bolus, then 8 mg/hour) or low-dose (40-mg bolus daily) pantoprazole intravenously for 3 da…