PROLONGED AND PROFOUND ACID INHIBITION IS CRUCIAL IN HELICOBACTER-PYLORI TREATMENT WITH A PROTON PUMP INHIBITOR COMBINED WITH AMOXICILLIN

Background: The aim was to investigate whether intragastric pH, meal-s timulated gastrin release, or demographic factors predict the outcome of Helicobacter pylori treatment. Methods: Thirty-six patients with H. pylori infection were investigated with 24-h intragastric pH registra tion and meal-stimulated gastrin release before and during treatment w ith 20 mg omeprazole twice daily and 750 mg amoxicillin twice daily fo r 14 days. The influence of age, sex, smoking, ethnic origin, pH, and gastrin on treatment outcome were analysed with logistic regression. R esults: Eradication of H. pylori was achieved in 18 of 34 (53%) patien ts. The univariate analysis showed that age, ethnic origin, more than 84.2% of the time with pH above 4, and continuous periods longer than 156 min with intragastric pH above 6 were significantly associated wit h successful treatment of H. pylori. In the multivariate analysis only the two pH variables were found to be independent factors for predict ing treatment outcome. Conclusion: The outcome of H. pylori treatment with omeprazole and amoxicillin may depend on several factors, such as age, ethnic origin, and a pronounced acid suppression. However, the o nly factor of independent importance in this study was prolonged and p rofound acid inhibition.