2-WEEK COURSE OF PANTOPRAZOLE COMBINED WITH 1 WEEK OF AMOXICILLIN ANDCLARITHROMYCIN IS EFFECTIVE IN HELICOBACTER-PYLORI ERADICATION AND DUODENAL-ULCER HEALING

Background: Experience with proton pump inhibitor-based triple therapy is predominantly with omeprazole-containing regimens. Aim: To investi gate the efficacy of a pantoprazole-based regimen, with either a 1 or 2-week course of antibiotic co-therapy, in eradicating H. pylori, heal ing duodenal ulcers and to assess the antibiotic sensitivity profiles of isolated H pylori strains. Methods: A single-blind, multicentre, pa rallel group comparison of patients with endoscopically proven, H, pyl ori associated, active duodenal ulceration, All patients received pant oprazole, 40 mg b,d, for 2 weeks, Patients were randomized to receive either 1 or 2 weeks of therapy with amoxycillin, 1 g b,d. and clarithr omycin 500 mg b.d. Patients were endoscoped at entry, at 14 days and a minimum of 4 weeks after cessation of all therapy, H, pylori status w as determined by urease reaction, histological assessment and culture from antral and body biopsies. Antibiotic sensitivity was determined u sing the agar dilution technique. Results: Sixty-seven patients were r andomized. One week co-therapy (n = 33): eradication efficacy, ITT = 7 9% (95% CI: 61-91%); ulcer healing efficacy (at 6-week visit) = 88% (9 5% CI: 72-97%), Two-week co-therapy (n = 34): eradication efficacy, IT T = 91% (95% CI: 76-98%; ulcer healing efficacy = 88% (95% CI: 73-97%) , Both regimens were well tolerated and no primary antibiotic resistan ce was noted, Conclusion: Pantoprazole-based triple therapy, with eith er 1 or 2 weeks of co-therapy with amoxycillin and clarithromycin, is effective in eradicating H. pylori and healing duodenal ulceration.