CLARITHROMYCIN, AMOXICILLIN AND H-2-RECEPTOR ANTAGONIST THERAPY FOR HELICOBACTER-PYLORI PEPTIC-ULCER DISEASE IN KOREA

Background: Effective anti-Helicobacter pylori therapies with few side -effects are needed. We previously showed that the regimen of amoxycil lin, clarithromycin and an H-2-receptor antagonist was effective in th e United States, The current study tested whether this therapy would a lso be successful in Korea. Methods: Patients with gastric or duodenal ulcers received amoxycillin (750 mg t.d.s.) plus clarithromycin (500 mg t.d.s.) for 2 weeks and nizatidine 300 mg at bedtime for 6 weeks, E ndoscopic examinations were performed before treatment and 4 or more w eeks after ending antimicrobial therapy, H, pylori status was confirme d by rapid urease testing and histological examination of gastric antr um and corpus biopsies using the Genta stain, Antibiotic resistance wa s tested using the E-test method. Cure was defined as no evidence of H . pylori infection 4 or more weeks after ending therapy. Results: Seve nty-two patients (59 males and 13 females; mean age 46 years), includi ng 35 with duodenal ulcers, 30 with gastric ulcers and seven with both , were studied. H. pylori infection was cured in 95.8% (69/72 patients ; 95% CI = 88.3-99.1%). Two of the treatment failures had culture data and one had pre-treatment resistance to clarithromycin. Smoking did n ot have an adverse effect on therapy, Ten patients (15%) developed sid e-effects during treatment, but all were mild and did not require trea tment interruption. No case of reinfection was noted during follow-up, Conclusion: The combination of amoxycillin, clarithromycin and an Hz- receptor antagonist is effective in Korean patients with H. pylori inf ection.