METRONIDAZOLE, OMEPRAZOLE AND CLARITHROMYCIN - AN EFFECTIVE COMBINATION THERAPY FOR HELICOBACTER-PYLORI INFECTION

Background: Successful treatment of Helicobacter pylori infection resu lts in cure of peptic ulcer disease. Multidrug regimens are needed to cure this infection. We studied the effectiveness and side effect prof ile of two antibiotics active against Helicobacter pylori, metronidazo le and clarithromycin, combined with omeprazole. Methods: We evaluated a combination therapy for H. pylori infection consisting of metronida zole (500 mg b.d.), omeprazole (20 mg b.d.), and clarithromycin (250 m g b.d.) for 2 weeks, followed by ranitidine 300 mg daily for 4 weeks. Results: Thirty-three patients with documented H. pylori infection wer e studied. Twenty had previously failed antimicrobial therapy, includi ng one with metronidazole-based triple therapy and eight with macrolid e-based therapy (five with clarithromycin-based therapy), and 11 with amoxycillin, tetracycline, and bismuth. H. pylori status was determine d by histopathology using the Genta stain and by culture. H. pylori st atus was determined at entry and 4 weeks after completing antimicrobia l therapy. The H. pylori infection was cured in 88% (95% CI = 72%-96%) including 90% of those who had failed previous anti-H. pylori therapi es. Mild side effects were reported by 18%. Conclusion: We conclude th at the combination of metronidazole, omeprazole and clarithromycin is an effective treatment for H. pylori infection.