TRIPLE THERAPY ERADICATED HELICOBACTER-PYLORI EQUALLY IN PATIENTS PRETREATED WITH OMEPRAZOLE OR RANITIDINE - A 12-MONTH FOLLOW-UP

The aim of this study was twofold: first, to investigate the effective ness of a standard triple therapy (tripotassium dicitrato bismuthate, 125 mg q.i.d., tetracycline hydrochloride 500 mg q.i.d., and metronida zole 500 mg t.i.d.) in eradicating Helicobacter pylori in patients wit h duodenal ulcer successfully healed with omeprazole or ranitidine; se cond, to examine the influence of the eradication on duodenal ulcer re currence rate after 12 months. Two hundred forty-five consecutive H. p ylori-positive patients with healed duodenal ulcer either with omepraz ole (20 mg/day, 126 patients) or with ranitidine (150 mg b.i.d., 119 p atients) given at random, began triple therapy for 15 days. H. pylori eradication was looked for 4-5 weeks later by culture of biopsy materi al, hematoxylin-eosin stain, and rapid urease test. H. pylori-eradicat ed patients were followed up for 12 months. Endoscopy was carried out at the end of the follow-up or whenever symptoms appeared. Five patien ts (2.0%) withdrew because of triple-therapy-related side effects. The eradication rate was 92% (220 of 240 patients); no difference was fou nd between those healed with omeprazole (93%, 114 of 123 patients) or ranitidine (91%, 106 of 117 patients). Of 220 successfully treated pat ients, 132 completed the 12-month follow-up. The duodenal ulcer recurr ence rate was 4% (5 of 132 patients); 3% (2 of 70) in the omeprazole g roup and 5% (3 of 62) in the ranitidine group healed. All the recurren ces were asymptomatic. H. pylori recurrence rate was 11% (14 of 132 pa tients); no difference was found between patients healed with omeprazo le (10%, 7 of 70 patients) or with ranitidine (11%, 7 of 62 patients). All the recurrent duodenal ulcers occurred in H. pylori-positive pati ents (36%, 5 of 14 patients). Standard triple therapy after duodenal u lcer healing with omeprazole or ranitidine eradicates H. pylori in com parable high rates. Side effects were mild and dropouts were only 2%. Ulcer recurrence rate 12 months after eradication was low and comparab le between those healed with omeprazole or ranitidine.