NEW research showed that a short course of antibiotics can reduce the risk of stomach bleeding due to long-term use of aspirin. This could improve the safety of aspirin, which is used as prevention for strokes and heart attacks, but can cause internal ulcer bleeding in some cases. As aspirin thins the blood, it can make ulcers bleed, and some of these ulcers are caused by Helicobacter pylori. Researchers analysed whether the removal of these bacteria through a short course of antibiotics would reduce the risk of bleeding.
In total, 30,166 patients participated in the .HEAT study and were tested for H. pylori. Those who tested positive were randomised to receive placebos or antibiotics and followed-up for 7 years. Those who received antibiotics were less likely to be admitted to hospital due to ulcer bleeding in the first 2.5 years, compared to the placebo group (6 versus 17, respectively). The first hospitalisation for ulcer bleeding in the placebo group occurred after 6 days, while the first hospitalisation in the group who received antibiotics occurred 525 days following treatment.
While protection decreased over time, the overall rate of hospitalisation rate for ulcer bleeding was lower than expected. This aligns with previous evidence that ulcer disease is declining. While the risk for people who are already using aspirin is low, researchers concluded that it would be worth testing and treating people when they first start taking it. Author Chris Hawkey, School of Medicine, University of Nottingham, UK, stated: “The long-term implications of the results are encouraging in terms of safe prescribing.”