Correspondence

Preventing Upper Gastrointestinal Bleeding in Patients with Helicobacter pylori Infection

N Engl J Med 2001; 345:67-68July 5, 2001

Article

To the Editor:

Chan et al. (March 29 issue)1 sought to determine whether eradication of Helicobacter pylori is “equivalent to maintenance treatment with omeprazole” in the secondary prevention of upper gastrointestinal bleeding in patients taking low-dose aspirin or other nonsteroidal antiinflammatory drugs. Unfortunately, their data do not make clear in how many of the patients with recurrent bleeding the attempted eradication of H. pylori was successful. The authors report an eradication rate of 91 to 93 percent among those who completed the study. This leaves a substantial number of patients who remained positive for H. pylori. What percentage of the patients who had recurrent bleeding were persistently infected?

Brian C. Jacobson, M.D.
Brigham and Women's Hospital, Boston, MA 02115
bjacobson@partners.org

1 References

1. 1

   Chan FKL, Chung SCS, Suen BY, et al. Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen. N Engl J Med 2001;344:967-973
   Full Text | Web of Science | Medline

Author/Editor Response

Dr. Chan replies:

To the Editor: None of the patients with recurrent bleeding who received eradication therapy were infected with H. pylori. In contrast, all patients with recurrent bleeding who received omeprazole remained positive for H. pylori.

Francis K.L. Chan, M.D.
Chinese University of Hong Kong, Shatin, Hong Kong, China
fklchan@cuhk.edu.hk