NO ADDITIONAL VALUE OF BISMUTH SUBCITRATE TO COMBINATION OMEPRAZOLE AMOXICILLIN THERAPY IN THE ERADICATION OF HELICOBACTER-PYLORI/

Background. We investigated whether addition of bismuth subcitrate (BS C, 4 X 120 mg) to a two week therapy scheme of omeprazole (OME, 2 X 40 mg)/amoxicillin (AMO, 4 X 500 mg) increases Helicobacter pylori eradi cation. Materials and Methods. Patients with dyspepsia underwent upper endoscopy. H. pylori positive patients were randomized to treatment A (OME/AMO, 83 patients) or treatment B (OME/AMO/BSC, 84 patients). Res ults. In 65 patients of group A (78%) H. pylori was eradicated as dete rmined from the histological assessment (Sydney classification) of ant rum and corpus biopsies. In comparison, in 68 patients of group B (81% ) H. pylori was eradicated (p = NS between groups). H. pylori eradicat ion in both groups was associated similarly with a decrease of inflamm ation and activity whereas atrophy and intestinal metaplasia were not affected. A positive association was revealed between the decrease of H. pylori score and the decrease oi both inflammation and activity sco res for antrum as well as corpus biopsies. Conclusions. Addition of BS C to OME/AMO does not increase H. pylori eradication in patients with dyspepsia. Eradication of H. pylori is associated with disappearance o f epithelial damage (inflammation and activity) in antral and corpus m ucosa.