ONE-WEEK TRIPLE THERAPY WITH LANSOPRAZOLE, CLARITHROMYCIN, AND METRONIDAZOLE TO CURE HELICOBACTER-PYLORI INFECTION IN PEPTIC-ULCER DISEASE IN KOREA

The efficacy and acceptability of classical bismuth triple therapy may be limited by poor patient compliance and adverse effects. It is wide ly agreed that improved, simpler, and reliable therapies are needed to cure Helicobacter pylori infection and foster patient compliance. We evaluated the efficacy and side effects of a Bazzoli triple therapy su bstituting lansoprazole for omeprazole for H. pylori infection in acti ve peptic ulcer in Korea (30 mg of lansoprazole, 250 mg of clarithromy cin, and 400 mg of metronidazole, all twice daily). H. pylori status w as evaluated by rapid urease test, histology, and culture at entry and four or more weeks after ending antimicrobial therapy. Fifty-eight pa tients (mean age: 43 years) with gastric (N = 30) or duodenal ulcer (N = 28) and H. pylori infection were studied. H. pylori was cured in 47 (81%, 95% CI = 69-90%). Mild side effects, including vomiting, diarrh ea, and itching, were observed in four patients (7%). Compliance avera ged 95%. Fifty-five ulcers (95%) were healed. Pretreatment pylorobulba r deformity was observed in 49 patients (85%), and in 43 (88%) the def ormity disappeared after treatment. Pretreatment metronidazole and cla rithromycin resistance was observed in 87% and 2% of patients, respect ively. The cure rate of H. pylori infection was significantly higher i n patients >50 years of age than those <50. Treatment with low-dose on e-week lansoprazole, clarithromycin, and metronidazole resulted in a r elatively low cure rate, but was well tolerated. Studies to define the optimal duration, dose, and dosing interval of this combination thera py in Korea are needed.