A 7-DAY HELICOBACTER-PYLORI TREATMENT REGIMEN USING CLARITHROMYCIN, OMEPRAZOLE AND TRIPOTASSIUM DICITRATO BISMUTHATE

Aim: To evaluate clarithromycin 500 mg t.d.s., tripotassium dicitrato bismuthate 240 mg b.d. and omeprazole 20 mg b.d. for 7 days as a Helic obacter pylori treatment regimen. Methods: The H. pylori status of dys peptic patients undergoing endoscopy was assessed by histology, cultur e and rapid urease testing of biopsies and by C-13-urea breath test. F ifty patients who were H. pylori-positive were treated with the above treatment regimen for 7 days. Those patients with active duodenal ulce rs present at endoscopy were given omeprazole 20 mg nocte for a furthe r 21 days. Not less than 28 days after completing treatment, all tests were repeated to reassess H. pylori status. Bacterial sensitivity of H. pylori cultures was determined and patients recorded any side-effec ts. Results: On an intention-to-treat basis, H. pylori infection was c ured in 90% (95% CI: 78-96%) of patients. Taste disturbance was experi enced by 35% patients. Compliance was excellent, with 96% patients tak ing more than 95% of tablets. Metronidazole resistance was 41% but all cultures were sensitive to clarithromycin. Conclusions: This 7-day tr eatment achieved a high level of cure of H. pylori infection with rela tively minor side-effects. It may have a role to play, particularly wh ere there is a high level of metronidazole resistance.