DOSE-RESPONSE OF OMEPRAZOLE COMBINED WITH AMOXICILLIN ON DUODENAL-ULCER HEALING AND ERADICATION OF HELICOBACTER-PYLORI

Background: Combination therapy using omeprazole and amoxycillin can c ure Helicobacter pylori infection, but data are controversial concerni ng the efficacy of this regimen. The present study investigated varyin g doses of omeprazole combined with a standard amoxycillin dose on duo denal ulcer healing and eradication of H. pylori, in order to find an optimal dose regimen. Methods: H. pylori-positive out-patients (n = 23 1) with duodenal ulcers were treated randomly and double-blind with ei ther omeprazole 20, 40 or 80 mg b.d. plus amoxycillin 1 g b.d. for 14 days. Patients with an unhealed ulcer after this therapy took omeprazo le 20 mg o.m. for another month. Results: After 2 weeks, ulcer healing rates in the three treatment groups were not statistically different (85, 82 and 93%. respectively). Treatment with omeprazole 80 mg b.d. w as significantly better in curing H. pylori infection (eradication rat e 69%) than treatment with omeprazole 20 and 40 mg b.d. (47 and 53%). Conclusions: Combination of either omeprazole 20 or 40 mg b.d. plus am oxycillin 1 g b.d., is not sufficiently effective to be recommended as an anti-H. pylori therapy. Omeprazole 80 mg b.d. combined with amoxyc illin is more efficient and well tolerated, but better treatment optio ns now exist to cure H. pylori infection.