LONG-TERM FOLLOW-UP AFTER ERADICATION OF HELICOBACTER-PYLORI WITH A COMBINATION OF OMEPRAZOLE AND AMOXICILLIN

Early studies have suggested that omeprazole may facilitate the eradic ation of Helicobacter pylori. Sixty patients with duodenal ulcer and H . pylori colonization were randomly assigned to receive either omepraz ole monotherapy (n = 30) or combination therapy with omeprazole and am oxycillin (n = 30) for a total duration of 6 weeks. Four patients rece iving monotherapy and three receiving combination therapy had to be wi thdrawn from the study. All (100%) duodenal ulcers healed in patients receiving combination therapy, and 25 out of 26 (96%) healed in the gr oup receiving monotherapy. H. pylori was eradicated in 22 out of 27 (8 2%) patients receiving combination therapy; only two ulcer relapses (9 %) occurred within 18 months in these 22 patients. Of the five patient s who remained H. pylori-positive after combination therapy, two relap sed during the 18-month follow-up. In the monotherapy group, all patie nts remained H. pylori-positive after treatment, and duodenal ulcer re lapsed in 16 out of 25 (64%) patients within the median follow-up of 1 8 months. Adverse events were not reported in the group treated with c ombination therapy; one patient receiving monotherapy reported severe headache. These results lend further support to existing data that H. pylori eradication prevents duodenal ulcer relapse and show that combi nation therapy with omeprazole and amoxycillin is effective and well t olerated.