ONE-WEEK LOW-DOSE TRIPLE THERAPY FOR HELICOBACTER-PYLORI IS SUFFICIENT FOR RELIEF FROM SYMPTOMS AND HEALING OF DUODENAL-ULCERS

Aim: To test the hypothesis that 1-week low-dose triple therapy for H. pylori is sufficient for relief from dyspeptic symptoms and healing o f duodenal ulcers. Methods: Fifty-nine out-patients with duodenal ulce rs and positive rapid urease test participated in this randomized, dou ble-blind, two-centre study. All patients were treated for 1 week with omeprazole 20 mg b.d., clarithromycin 250 mg b.d. and metronidazole 4 00 mg b.d. In a double-blind fashion, patients were then randomly trea ted for another 3 weeks with either omeprazole 20 mg once daily or an identical-looking placebo. Patients were investigated endoscopically b efore treatment for H. pylori, after 2 weeks and after 4 weeks. H, pyl ori infection was assessed by a C-13-urea breath test at the time of e nrolment and 4 weeks after cessation of any study medication. Results: Fifty-two patients were included in the all patients treated' analysi s of efficacy. The overall H. pylori cure rate was 96% (95% CI = 87-10 0%), with no difference between the treatment groups. After 2 weeks du odenal ulcer healing was confirmed in 91% (95% CI = 80-100%) of patien ts treated with omeprazole and in 76% (95% CI = 60-91%) in the placebo group (P = 0.14). After 4 weeks all ulcers had healed. Relief from dy speptic symptoms and adverse events (13.8 and 16.7%) did not differ be tween the treatment groups. Conclusions: One-week low-dose triple ther apy consisting of omeprazole, clarithromycin and metronidazole is a hi ghly effective and well-tolerated approach to the cure of H. pylori in fection in patients with a duodenal ulcer. Our data suggest that conti nuation of antisecretory drug therapy beyond anti-II. pylori therapy i s actually excessive regarding relief from dyspeptic symptoms and heal ing of duodenal ulcers.