OMEPRAZOLE, BISMUTH AND CLARITHROMYCIN IN THE SEQUENTIAL TREATMENT OFHELICOBACTER-PYLORI INFECTION

Aims: To assess the therapeutic potential of clarithromycin, a new mac rolide with high anti-Helicobacter pylori activity, given with bismuth salts and omeprazole in different regimens aimed at simplifying the t reatment of H. pylori-related gastritis. Methods: Eighty-eight patient s with proven H. pylori infection and gastritis were treated with one of the following four regimens: omeprazole 40 mg/day for one week (gro up A, n = 14); omeprazole 40 mg/day for one week followed by clarithro mycin 1 g/day for 2 weeks (group B. n = 26); omeprazole 40 mg/day for one week followed by tripotassium dicitrato bismuthate 480 mg/day and clarithromycin 1 g/day, both for two weeks (group C, n = 26); and trip otassium dicitrato bismuthate 480 mg/day and clarithromycin 1 g/day fo r two weeks (group D, n = 22). Presence of H. pylori, histology and el ectron microscopy were assessed at entry and four weeks after the end of each treatment. Results: Omeprazole alone had no effect on H. pylor i status. The highest eradication rate was obtained in group C patient s (81%), a proportion significantly greater than that observed in grou p B (50%, P < 0.03) or group D patients (55%, P < 0.05). Conclusion: S equential treatment may be a useful option in the treatment of H. pylo ri-related gastritis.