WEEK TREATMENT WITH OMEPRAZOLE, CLARITHROMYCIN AND TINIDAZOLE OR LANSOPRAZOLE, AMOXICILLIN AND METRONIDAZOLE FOR CURE OF HELICOBACTER-PYLORI INFECTION IN DUODENAL-ULCER PATIENTS

We defined optimal Helicobacter pylori (Hp) treatment as Hp eradicatio n rate about 90%, well-tolerated with few side-effects. Two centers ca rried out randomized trials including 90 patients (74% men, 26% women, ages ranging from 18 to 65, mean age 42 +/- 8) with active duodenal u lcers (DU). Patients were treated with the combination of Omeprazole ( O) 20 mg bd+Clarithromycin (C) 250 mg bd+Tinidazole (T) (500 mg bd) or with Lansoprazole (L) 15 mg bd+Amoxicillin (A) 750 mg bd+Metronidazol e (M) 500 mg bd administered for one week. The DU healing rate was eva luated by endoscopy and the Hp status by rapid urease CLO-test and C-1 4-urea breath test (UBT). The healing rate of the DU in a group treate d with the combination of O+C+T was 91% and in group treated with L+AM was 93%. The eradication of Hp in group O+C+T and L+A+M averaged 91% and 87%, respectively. There was no statistically significant differe nce in the DU healing rate and the Hp eradication rate between these t wo groups. Both treatments were accompanied by a marked rise in the ba sal and postprandial plasma gastrin levels and the rise in the intraga stric pH but these alterations returned to the pre-treatment values 4 weeks after the termination of the therapy. Both treatments were well tolerated and the only side effect was the taste disturbance observed in few patents treated with O+C+T. None of patients discontinued the t reatment because of the adverse events. We conclude that one week trea tment using O+C+T or L+A+M are highly and equally effective in the hea ling of DU and in the eradication of Hp.