One-week low-dose triple therapy is effective in treating Helicobacter pylori-infected patients with bleeding peptic ulcers

Proton pump inhibitor (PPI)-based triple therapy, which combines a PPI and two antibiotics, is highly effective in eradicating Helicobacter pylori inf ection in peptic ulcer patients, even if given fur only 1 week. However, th e application of this regimen in patients with bleeding ulcers has not been adequately investigated. We studied the effectiveness of triple therapy in treating 122 patients with proven H. pylori infection, and bleeding stigma ta on endoscopy; 97 had duodenal ulcer (DU), 15 had gastric ulcer (GU), and 10 had both types of ulcers. A regimen of omeprazole (20 mg), metronidazol e (500 mg), and clarithromycin (250 mg) twice daily was administered for 1 week as soon as the patient could eat normally after bleeding, followed by omeprazole (20 mg) daily for 3 additional weeks. Follow-up endoscopy and C- 13-urea breath tests (UBTs) were per-formed at least 4 weeks after triple t herapy. A total of 104 patients completed the study, 83 with DU, 12 with GU , and nine with both. The overall ulcer healing rate was 97.1% and the erad ication rate was 91.3%. Patients with and without H. pylori eradication did not differ significantly in terms of age, gender, UBT titer, units of bloo d transfused, or interval between endoscopy and the beginning of triple the rapy. We conclude that 1-week low-dose PPI-based triple therapy is effectiv e in eradicating H. pylori infection in patients with bleeding peptic ulcer s. When followed by 3 weeks of additional PPI treatment, a satisfactory ulc er healing rate can also be achieved.