OMEPRAZOLE PLUS AMOXICILLIN FOR CURE OF HELICOBACTER-PYLORI INFECTION

Background: Omeprazole plus amoxicillin may cure Helicobacter pylori i nfection. However, the published results vary rather widely, and the f actors influencing the treatment success remain unclear. Methods: Four hundred and twenty-three H. pylori-positive patients were treated wit h 1- or 2-week regimens comprising 40 mg or 80 mg omeprazole and amoxi cillin in 11 prospective protocols. A complete set of data was availab le for 405 patients (ulcer disease, n = 383; dyspepsia, n = 22) and wa s submitted to uni- and multi-variate statistical analyses to elucidat e the factors affecting the cure rates of the infection; 18 patients w ere lost to follow-up. Results: The overall proportion of H. pylori cu re was 76%. Insufficient compliance (p < 0.001), a short duration of t reatment (p < 0.001), smoking (p = 0.003), and omeprazole pretreatment (p = 0.041) were the significant independent factors predicting treat ment failure, whereas advanced age (p = 0.002), high scores of grade a nd of activity of gastritis (p = 0.035 and p = 0.019, respectively), a nd gastric ulcer disease (p = 0.058) were independent factors predicti ng treatment success. Conclusions: Several patient- and therapy-relate d factors diminish or increase the rate of H. pylori cure obtained by omeprazole/amoxicillin. These should be considered in future studies c omparing different treatment regimens for curing H. pylori infection a nd also when designing treatment regimens applicable for routine clini cal practice.