Therapy

Give patients with a bleeding peptic ulcer a proton-pump inhibitor (e.g. omeprazole) ^a

Why?

• Omeprazole reduces rebleeding and the need for surgery, though there is no clear effect on mortality ^a
• Omeprazole is more effective than cimetidine ^a at preventing rebleeding.

Bleeding peptic ulcer: omeprazole reduces rebleeding and emergency surgery

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
bleeding peptic ulcer a	omeprazole	placebo	continued or further bleeding at weeks	36%	70% (46% to 83%)	4 (3 to 7)
bleeding peptic ulcer	omeprazole	placebo	surgery needed at 30 days	28%	69% (35% to 85%)	6 (4 to 14)
bleeding peptic ulcer or visible vessel on endoscopy a	omeprazole	cimetidine	rebleeding at 14 days	24%	83% (29% to 96%)	5 (3 to 14)