EFFICACY AND TOLERABILITY OF A ONE-WEEK TRIPLE THERAPY CONSISTING OF PANTOPRAZOLE, CLARITHROMYCIN AND AMOXICILLIN FOR CURE OF HELICOBACTER-PYLORI INFECTION IN PATIENTS WITH DUODENAL-ULCER

Background: Previous studies have shown that one-week triple therapy c onsisting of omeprazole, clarithromycin and amoxycillin may cure Helic obacter pylori infection in the vast majority of patients. The present study was designed to test the hypothesis that a triple therapy with pantoprazole, clarithromycin and amoxycillin cures the infection in gr eater than or equal to 80% of duodenal ulcer patients infected with H. pylori. Methods: In an open two-centre study, 60 duodenal ulcer patie nts were treated with pantoprazole 40 mg b.d., clarithromycin 500 mg b .d. and amoxycillin 1 g b.d, for 1 week. During the second week patien ts received pantoprazole 40 mg once in the morning. We assessed H. pyl ori infection before treatment and 4 weeks after cessation of the stud y medication by a rapid urease test, histology after Warthin-Starry st ain and a C-13-urea breath test. Results: Sixty patients (42 males, me an age 47.4 years) entered the trial. All patients were infected with H. pylori. One patient was withdrawn from the study because of allergy to penicillin and six patients were protocol violators. H. pylori inf ection was cured in 47 out of 53 patients who completed the trial acco rding to the protocol (89%; 95% CI: 80-97%) and in 49 of 60 patients i ncluded in the trial (82%; 95% CI: 72-92%). Four weeks after the last administration of study drugs, 55 out of 60 ulcers had healed (92%). T wenty-nine patients reported 51 adverse events that were mostly mild t o moderate. Conclusions: One-week triple therapy consisting of pantopr azole, clarithromycin and amoxycillin is a simple and effective approa ch to the cure of H. pylori infection in patients with duodenal ulcer, In those patients who took the drugs as prescribed the H. pylori cure rate was 89%, with the lower 95% confidence limit being 80%.