COMPARISON OF 2 LOW-DOSE ONE-WEEK TRIPLE THERAPY REGIMENS WITH AND WITHOUT METRONIDAZOLE FOR CURE OF HELICOBACTER-PYLORI INFECTION

Background: One-week triple therapy consisting of omeprazole 20 mg b.d ., clarithromycin 250 mg b.d. and tinidazole 500 mg b.d. is an effecti ve therapy for H. pylori infection with a cure rate of 93%. We therefo re compared two similar 1-week regimens consisting of a lansoprazole, clarithromycin and either metronidazole or tetracycline in a prospecti ve study. Methods: Two cohorts, each of 60 patients suffering from H. pylori infection associated with peptic ulcer disease or ulcer-like dy spepsia, were treated for 1 week with either lansoprazole 30 mg b.d., clarithromycin 250 mg b.d. and either metronidazole 400 mg b.d. (cohor t A, n = 60) or tetracycline 300 mg b.d. (cohort B, n = 60). Four week s after treatment, cure of H. pylori infection was evaluated by endosc opy using rapid urease testing together with histology. Results: In co hort A, 55 patients out of 60 showed cure of H. Pylori infection (92%) ; the treatment was well tolerated, but three patients suffered from s ide-effects. In cohort B, which was free of metronidazole, 50 out of 6 0 patients showed cure of H. pylori infection (83%); two patients repo rted side-effects. The differences between the two cohorts were not st atistically significant. Conclusion: Triple therapy for 1 week with la nsoprazole as the antisecretory agent seems to be as effective as is r eported for omeprazole-based regimens.