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High-dose intravenous therapy with proton-pump inhibitors (PPIs) reduces the risk for rebleeding in patients with bleeding peptic ulcers. Thus, IV PPI therapy is the standard of care for these patients after endoscopy and might also be beneficial before endoscopy. As these benefits have become clear, many hospitals have lifted any initial cost-containment restrictions that they had on IV PPI use.
Investigators in Canada set out to determine whether such a shift in restrictions at their own hospital led to any changes in the frequency of or indications for use of IV pantoprazole. Data were compared retrospectively for two groups of patients: all who received IV pantoprazole when only gastroenterologists could prescribe the drug (November 1999…