Mit den heutigen Methoden zur Streβblutungsprophylaxe ist es gelungen, die Häufigkeit manifester Streβblutungen von ca. 16 auf 3-4% zu reduzieren. Die Mortalität konnte aber nicht signifikant beeinfluβt werden. Wir sind heute trotz zahlreicher Fortschritte noch weit von einer idealen Streβblutungsprophylaxe entfernt. Ein nicht gelöstes Problem stellen mechanisch beatmete Patienten mit nicht funktionie-rendem Magen-Darm-Trakt dar. Wird das Magensaft-pH auf Werte über 5 angehoben, nimmt zwar die Blutungshäufigkeit ab, dafür aber die Zahl der nosokomialen Pneumonien zu. In dieser Situation könnte in Zukunft eine kombinierte Behandlung mit einem potenten Säuresekretionshemmer und einer antibakteriell im oberen Gastrointestinaltrakt wirksamen Substanz Abhilfe schaffen.

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