HIGH-DOSE OMEPRAZOLE PLUS AMOXICILLIN OR CLARITHROMYCIN CURES HELICOBACTER-PYLORI INFECTION IN DUODENAL-ULCER DISEASE

Treatment with omeprazole plus amoxicillin or clarithromycin resulted in encouraging Helicobacter pylori cure rates in pilot and controlled studies, The present prospective randomized study was designed to comp are the efficacy and safety of amoxicillin and clarithromycin as const ituents of omeprazole-enhanced antibiotic therapy of H. pylori infecti on. Fifty patients with active duodenal ulcer disease and histological ly and/or culturally confirmed H. pylori colonization of the gastric m ucosa were treated with omeprazole (day 1-14: 40 mg twice daily, day 1 5-42: 20 mg once in the morning). The patients were randomly assigned to receive either amoxicillin (1 g twice daily; group I: n 25) or clar ithromycin (500 mg twice daily; group II: n = 25) during the first 2 w eeks of treatment. The patients of group I and II had comparable demog raphic and clinical characteristics. One patient of group I was lost t o followup. H. pylori infection was cured in 87.5% of group I and 84.0 % of group II (p = 1.00). All ulcers had healed after 6 weeks of omepr azole treatment. Pain relief occurred within the first day of treatmen t in the majority of patients of both groups (p = 0.89). Minor side ef fects were recorded in 6 patients of group I and in 4 patients of grou p II(25 vs. 16%; p = 0.50). In 1 female patient amoxicillin had to be withdrawn after 3 days because of nausea and emesis. In conclusion, 2 weeks of treatment with omeprazole plus amoxicillin or clarithromycin are highly and equally effective regimens to cure H. pylori infection in patients with duodenal ulcer disease.