Comparative treatment of Helicobacter pylori-positive duodenal ulcer usingpantoprazole at low and high doses versus omeprazole in triple therapy

Background. Helicobacter pylori eradication has become the standard treatme nt for peptic ulcer disease. H. pylori-eradicating triple therapy with omep razole plus two antibiotics has been used until recently; however, the effi cacy of pantoprazole and antibiotics for H. pylori eradication has not been researched thoroughly until now. The aim of this randomized clinical trial was to verify the efficacy of triple oral therapy comparing the effects of pantoprazole using two different doses versus omeprazole twice daily in H. pylori eradication, in ulcer healing and relapses, and in gastritis improv ement. Materials and Methods. We enrolled 243 patients with H. pylori-positive duo denal ulcer and randomized them into three treatment groups: 84 patients (g roup Ome40) were assigned to receive omeprazole, 20 mg twice daily, plus am oxicillin, 1 gm twice daily, and clarithromycin, 500 mg twice daily for 10 days; 79 patients (group Pan40) were treated with pantoprazole, 40 mg daily , plus amoxicillin and clarithromycin at the same doses as those of group O me40; and 80 patients (group Pan80) were treated with pantoprazole, 40 mg t wice daily, plus amoxicillin and clarithromycin at the same doses as those of group Ome40. Results. Ulcer healing was observed in 81 of 84 patients (96.4%) in group O me40; in 66 of 79 patients (83.5%) in group Pan40; and in 77 of 80 patients (96.2%) in group Pan80. H. pylori was eradicated in 79 of 84 patients (94% ) in group Ome40; in 63 of 79 patients (79.7%) in group Pan40; and in 75 of 80 patients (93.7%) in group Pan80. Conclusions. We found that 10-day triple therapy with amoxicillin, clarithr omycin, and either pantoprazole, 80 mg daily, or omeprazole, 40 mg daily, i s highly effective in ulcer healing and is very well tolerated, achieving t he 90% cure recommended for an ideal first-line anti-H, pylori positive duo denal ulcer treatment regimen.