AN AUDIT OF LOW-DOSE TRIPLE THERAPY FOR ERADICATION OF HELICOBACTER-PYLORI

Aims. Standard triple therapy remains the recommended first line treat ment for Helicobacter pylori in New Zealand. The real eradication rate achieved in busy hospital clinics may be different from data obtained from clinical trials outside of New Zealand. Methods. One hundred and thirty patients with proven H pylori infection (by at least two tests ) were treated with low dose triple therapy (DeNol 1 qid, tetracycline 250 mg qid and metronidazole 200 mg qid for 2 weeks; dosing with meal s and at night); 83 were given a standard prescription for triple ther apy (dispensed in bottles) and 47 were given a medication pack with ti mes of dosing clearly marked. Eradication was proven by a negative C-1 3 urea breath test at least 4 weeks after finishing treatment. Results . Follow up urea breath test was obtained in 120 patients (92%). The e radication rate for separate bottles was 79% and for the medication pa ck 76%. Compliance was estimated to be greater than 90% in 92% of pati ents who attended for followup, Il pylori culture and sensitivity resu lts were available for 41 patients, Overall rate of metronidazole resi stance was 32%. The eradication rate for metronidazole sensitive strai ns was 89% and for resistant strains 46%, Mild side effects were repor ted in 10% and moderate side effects in 10%. NO patient stopped treatm ent because of side effects. There wax no effect of age, ethnicity, sm oking, alcohol intake, pretreatment with H-2-antagonists or endoscopic diagnoses on eradication rates, Conclusion. The low dose triple thera py has an acceptable real eradication rate. The most important determi nant of success was metronidazole resistance. The eradication rate was not improved by using medication packs.