OMEPRAZOLE-AMOXICILLIN THERAPY FOR ERADICATION OF HELICOBACTER-PYLORIIN DUODENAL-ULCER BLEEDING - PRELIMINARY-RESULTS OF A PILOT-STUDY

Thirty-five patients with duodenal ulcer bleeding and Helicobacter pyl ori-colonization were assigned to receive 2 x 20 mg omeprazole and 3 x 750 mg amoxycillin daily for 2 weeks. Eradication was defined as no e vidence of H. pylori infection by urease test and by histology 4 weeks after completion of therapy. Two patients were lost to follow up. All ulcers healed completely (100% ulcer healing rate). Twenty-nine out o f the 33 patients were H. pylori-negative (87.9% eradication rate). Th ree patients complained of typical side effects of amoxycillin (9.1% s ide effect rate). The patients were prospectively followed for 12 mont hs. After ulcer healing, no maintenance therapy was given. One of the 29 patients in whom H. pylori eradication had been successful suffered a second ulcer hemorrhage with H. pylori reinfection (3.4% relapse ra te of ulcer bleeding), and this was managed endoscopically. Recurrent ulcer hemorrhage occurred in 2 out of 4 H. pylori-resistant patients. At the end of the follow-up period, of the patients in whom H. pylori eradication had been initially successful, only the patient with re-bl eeding remained reinfected. The 4 H. pylori-resistant patients showed persistent H. pylori colonization. In conclusion, omeprazole plus amox ycillin is a safe and effective treatment for eradicating H. pylori; t his treatment reduces the relapse rate of duodenal ulcer bleeding.