The efficacy of omeprazole-based short-term triple therapy in Helicobacterpylori-positive older patients with dyspepsia

OBJECTIVE: To evaluate the efficacy of 1-week triple therapy with omeprazol e, clarithromycin,and tinidazole (OCT) in Helicobacter pylori-positive olde r patients with dyspepsia. DESIGN: A prospective, nonrandomized therapeutic study. SETTING: The primary care and referral center of a gastroenterological outp atient clinic at a central university hospital serving an urban population (>1 million) in Israel. PARTICIPANTS: The study group consisted of 134 patients (71 men, and 63 wom en) more than 60 years old who were referred for evaluation of symptoms of dyspepsia and were endoscopically diagnosed as H. pylori positive. The pati ents were divided into two groups: those who received their first course of anti-H. Pylori therapy during this study (Group 1) and those who had previ ously received standard metronidazole and bismuth combination therapies tha t failed to eradicate the H, pylori (Group 2). MEASURMENTS: All the patients underwent upper gastro-intestinal endoscopy, and H. pylori infection was confirmed by a rapid urease test (CUTest) and/o r histological staining. Therapeutic efficacy was assessed by a C-13-urea b reath test 4 weeks after completion of treatment. RESULTS: The mean age of the study population was 68.8 years (range 60-87). There were 112 patients in Group 1 and 22 patients in Group 2. Endoscopic findings were: gastritis tin 46, gastric ulcer (8), duodenal ulcer (52), an d duodenitis (28). The H. pylori eradication rate was significantly higher in Group 1 patients (104/112, 92.9%) than in patients of Group 2 (15/22, 68 .2%). There was no difference in the eradication rate in relation to gender , endoscopic diagnosis, more advanced age, place of birth, or smoking habit s. The compliance in both groups was equally good, and no major side effect s were recorded. CONCLUSIONS: A 1-week OCT triple therapy is well tolerated and effective as first line therapy for PI. pylori among older people. It is less effective in patients previously treated.