CURE OF HELICOBACTER-PYLORI INFECTION BY OMEPRAZOLE-CLARITHROMYCIN-BASED THERAPY IN NONHUMAN-PRIMATES

Rhesus monkeys raised in colonies tend to become naturally infected by Helicobacter pylori early in life. Earlier attempts to cure H. pylori infection with a 10-day triple therapy (metronidazole. amoxicillin, a nd peptobismol) were only partially (60%) successful, probably because of preexisting metronidazole resistance. This study was carried out t o determine the efficacy of an alternative clarithromycin-omeprazole-b ased therapy for curing H. pylori infection in Rhesus monkeys (Macaca mulatta), and to examine histologic and serologic correlates of curing , Five monkeys were endoscoped under ketamine anesthesia. Histology an d culture of gastric biopsies and serologic tests demonstrated that th ey were H. pylori-positive. Two animals had not received prior anti-H. pylori treatment, while three other animals had failed triple therapy and carried metronidazole-resistant H. pylori strains. Quadruple ther apy with omeprazole, clarithromycin, amoxicillin, and bismuth subsalic ylate was given for 10 days to these five animals. All five animals we re cured of the infection, and remained H. pylori-free, based on histo logy and culture at regular intervals for the 5 months post-therapy du ring which they were followed. Gastritis scores and anti-H. pylori IgG levels decreased in each animal during this period to levels characte ristic of uninfected animals. These results indicate that an omeprazol e-clarithromycin-based regimen can cure H. pylori infection in Rhesus monkeys, with resolution of abnormal histology and serologic responses . They suggest that this preclinical animal model is useful for testin g new anti-H. pylori therapies.