How to stop bleeding: Kill the germ, disarm the aspirin


Wednesday, March 28th 2001, 12:00 am
By: News On 6



Researchers have discovered a new way to cut down on bleeding ulcers suffered by some heart patients on daily aspirin: Give them antibiotics.

The antibiotics kill a common germ that appears to trigger or heighten the damage done by aspirin.

Daily aspirin is widely prescribed to prevent blood clots in people with heart disease. But aspirin can cause bleeding ulcers. Many such patients must take daily doses of an acid-cutting drug to treat their ulcers.

Taking antibiotics for a week to knock out the germ could be a cheaper and more convenient approach for these people.

``We're not committing them to chronic, more expensive medication,'' said Dr. Sidney Smith, a University of North Carolina cardiologist and chief science officer of the American Heart Association. ``It will certainly affect my practice.''

The study was conducted by Hong Kong researchers and was published in Thursday's New England Journal of Medicine.

Scientists have known for several years that a bacterium, Helicobacter pylori (pronounced HEEL-ah-koh-BACK-ter pie-LOR-ee), causes many ulcers, even in patients not taking aspirin.

The researchers studied 400 patients taking either aspirin for heart ailments or naproxen, a nonsteroidal anti-inflammatory drug, for pain from various conditions. Some patients got the acid-cutter omeprazole (pronounced Ah-MIP-prah-zole) every day. Others took antibiotics for a week, and then a placebo.

Six months later, the antibiotic had worked just as well as the acid-cutter in patients using aspirin. There was a 1 percent to 2 percent chance of bleeding ulcers for either the acid-cutter or antibiotics.

The antibiotic technique failed with naproxen. There was a 19 percent chance of bleeding ulcers with antibiotics, but a 4 percent chance with the acid-cutter.

Francis Chan, who led the study at Chinese University, said it is unclear why the germ appears to aggravate aspirin's tendency to cause bleeding.