DUAL THERAPY USING A DOUBLE DOSE OF LANSOPRAZOLE WITH AMOXICILLIN VERSUS TRIPLE THERAPY USING A DOUBLE DOSE OF LANSOPRAZOLE, AMOXICILLIN, AND CLARITHROMYCIN TO ERADICATE HELICOBACTER-PYLORI INFECTION - RESULTSOF A PROSPECTIVE RANDOMIZED OPEN STUDY

Objectives: The eradication of Helicobacter pylori is recommended in d uodenal ulcer disease. The aim of this randomized open trial was to ev aluate and compare H. pylori eradication and safety after a dual thera py consisting of lansoprazole (30 mg b.i.d.) and amoxicillin (1 g b.i. d.) versus a triple therapy consisting of lansoprazole (30 mg b.i.d.), amoxicillin (1 g b.i.d.), and clarithromycin (500 mg b.i.d.) administ ered from day 1 to day 14. Methods: All patients with an ulcer receive d lansoprazole (30 mg) from day 15 to day 28. H. pylori status was det ermined from antral biopsies using histology, culture, and polymerase chain reaction (PCR) upon inclusion and 1-3 months after the end of th e treatment. Results: Of the 50 patients included in the study, five d id not adhere to the protocol. H. pylori eradication was obtained in 3 7.5% of the patients receiving lansoprazole-amoxicillin (n = 9/24) and in 95.2% of the patients receiving lansoprazole-amoxicillin-clarithro mycin (n = 20/21, p < 0.0002). Minor side effects appeared in 8.3% of the cases during dual therapy (n = 2/24) and in 52% during triple ther apy (n = 13/22, p < 0.001). These side effects consisted mainly of dia rrhea and a metallic taste. Conclusion: Concommitant administration of double doses of lansoprazole with amoxicillin and clarithromycin is v ery efficacious against H. pylori infection compared with dual therapy . (Am J Gastroenterol 1998;93:1531-1534. (C) 1998 by Am. Coll. of Gast roenterology).