SHORT-TERM LOW-DOSE TRIPLE THERAPY FOR THE ERADICATION OF HELICOBACTER-PYLORI

Background: Helicobacter pylori infection causes antral gastritis and is strongly associated with duodenal ulcer relapse. Eradication of H. pylori infection may be difficult to achieve due to antimicrobial resi stance, side effects and poor patient compliance. Objective: To evalua te the efficacy, tolerability and patient compliance of short-term tri ple therapy with clarithromycin, omeprazole and tinidazole. Methods: T riple therapy, comprising clarithromycin 250 mg twice daily, omeprazol e 20 mg once daily and tinidazole 500 mg twice daily, was administered to 65 patients with H. pylori gastritis for 1 week. H. pylori infecti on before and after treatment was determined by histology, the urease test and the C-13-urea breath test. Upper gastrointestinal endoscopy, during which four antral biopsy specimens were taken, and the C-13-ure a breath test were performed in all patients before treatment and at 1 and 6 months after treatment. Drug tolerance was evaluated by patient interviews and compliance by counting returned pills at the end of tr eatment. Results: Sixty-three patients with H. pylori infection were s tudied. One month after treatment, on intent-to-treat analysis, H. pyl ori infection had been eradicated in 62 out of 65 patients (95.4%), co nfirmed by a negative urease test, C-13-urea breath test and histologi cal examination of antral biopsy specimens. All patients were free of infection 6 months after treatment ended. All but one patient complete d treatment and took more than 90% of the prescribed medication. There were no side effects except for one case of mild nausea (not severe e nough to stop treatment) and one case of urticaria, following which tr eatment was withdrawn. Conclusions: Short-term, low-dose triple therap y with clarithromycin, omeprazole and tinidazole is highly effective f or the eradication of H. pylori infection. The lack of side effects an d good compliance are important for successful eradication.