Eradication of Helicobacter pylori infection with proton pump-based tripletherapy in patients in whom bismuth-based triple therapy failed

To study the effects of treatment of Helicobacter pylori infection in a hyp erendemic population, 143 infected patients from the region of Narino, Colo mbia, were heated for 2 weeks with clarithromycin (500 mg twice a day), amo xicillin (1 g twice a day), and either lansoprazole (30 mg twice a day) or omeprazole (30 mg twice a day). All patients belong to a low socioeconomic strata, had multifocal atrophic gastritis documented by gastric biopsies, a nd had been treated previously and unsuccessfully for 2 weeks with bismuth subsalicylate (262 mg four times a day), amoxicillin (500 mg three times a day), and metronidazole (400 mg three times a day). C-13-urea breath tests were performed 6, 12, 24, and 60 weeks after completing therapy. The C-13-u rea breath test was negative in 79.7% of patients 1 month after finishing t herapy, and in 69.2% of patients 1 year after finishing treatment. There we re no differences in eradication rates between patients treated with omepra zole versus lansoprazole. Dyspepsia symptoms decreased from 74% in patients at baseline to 19% at the time of finishing treatment. In low-socioeconomi c status populations with hyperendemic infection, triple therapy using omep razole or lansoprazole plus clarithromycin and amoxicillin is an effective alternative when previous standard bismuth-based triple therapy has failed.