ADDITION OF BISMUTH SUBNITRATE TO OMEPRAZOLE PLUS AMOXICILLIN IMPROVES ERADICATION OF HELICOBACTER-PYLORI

Objective: To evaluate whether the addition of bismuth subnitrate to a dual oral therapy regimen with omeprazole plus amoxycillin could impr ove Helicobacter pylori eradication, Methods: Fifty consecutive Helico bacter pylori-positive patients were randomly enrolled to receive eith er (A) bismuth subnitrate (300 mg q,d,s,), omeprazole (20 mg b,d,) and amoxycillin (500 mg q.d.s.), or (B) omeprazole (20 mg b.d,) and amoxy cillin (500 mg q,d,s.). Both groups (n = 25 each) received the medicat ion for 14 days. H. pylori status was reassessed 30 days after complet ion of the therapy in order to evaluate eradication rates. Results: Si x patients were lost to follow-up and therefore excluded from the stud y (three patients from each group). One patient from Group B withdrew from the study because of side-effects. The addition of bismuth subnit rate to omeprazole and amoxycillin significantly improved its efficacy in eradicating H, pylori, with 72% (18/25) eradication in Group A and 52% (13/25) in Group B (P = 0.027). The addition of bismuth subnitrat e to dual oral therapy was also capable of improving the healing of pe ptic ulcers when compared with dual oral therapy alone (100%, 8/8 vs, 58%, 4/7; P = 0.021). Conclusion: Our results demonstrate that the add ition of bismuth subnitrate to dual oral therapy enhances H, pylori er adication, and improves healing of peptic ulcers.