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Ulcer Patients Tolerate Aspirin Therapy Following Antibiotics


After six months, the risk of recurrent ulcers was 2% in aspirin patients given antibiotics, compared to 1% in those still taking Prilosec. This result, it's important to point out, did not work with other NSAIDS, in this case naproxen (drugs such as Aleve), but just aspirin. In fact, the risk of recurrent ulcers was high among people taking other NSAIDS compared to those still taking Prilosec.

"These findings show that if you have H. pylori infection and you require aspirin and are at risk of developing peptic ulcer disease, [antibiotics] can be as effective as giving antiulcer agents," Chan says. "For other nonsteroidal anti-inflammatory drugs, the story is more complicated, however. For a chronic NSAID user with a history of ulcer disease, the best treatment is still an antiulcer agent like [Prilosec]."

But gastroenterologist and H. pylori expert Phillip P. Toskes, MD, of the University of Florida College of Medicine in Gainesville, says he remains unconvinced that antibiotics is a prudent therapeutic option for bleeding ulcer patients on aspirin therapy. The study by Chan and colleagues was too small to answer the question, he says.

"If I really felt that one of my ulcer patients was at risk for rebleeding, but needed to take aspirin for stroke or heart attack prevention, I would still use [Prilosec]," he says. "At this point, the only proven course for these patients is [Prilosec]. And since a generic form of the drug has recently been approved, the cost factor may not be such an issue in the future."


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