We read with interest the article titled “Famotidine Versus Pantoprazole for Preventing Bleeding in the Upper Gastrointestinal Tract of Critically Ill Patients Receiving Mechanical Ventilation.”1 In this retrospective study, Ojiako et al conclude that famotidine and pantoprazole are similarly effective for preventing bleeding in the upper gastrointestinal tract in patients receiving mechanical ventilation.

Several points need to be discussed. This study was retrospective and had different sample sizes in the 2 groups (522 for famotidine and 95 for pantoprazole). Is it possible that doctors used pantoprazole for those cases that were more severe? This selective use could perhaps be a contributing factor to the greater number of bleeding patients in the pantoprazole group.

The dose and route of pantoprazole may not have been sufficient to prevent bleeding in this study. A stable blood clot in a peptic ulcer...

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