EFFICACY OF METRONIDAZOLE-BASED TRIPLE THERAPY ON ERADICATING HELICOBACTER-PYLORI POSITIVE PEPTIC-ULCERS IN MAINLY SAUDI PATIENTS

Objectives: To evaluate the short-term efficacy of triple antibiotics on eradicating H.pylori from peptic ulcer patients. Design: Prospectiv e study. Patients and methods: Peptic ulcer patients of both sexes wer e included if they were H.pylori positive on culture and/or histology and were aged between between 18-75 years. Patients were excluded if t hey had severe coagulopathy, If the females were pregnant and if antib iotics or non-sterioidal anti-inflammatory drugs had been recently use d. All patients received a combination of metronidazole 500 mg PO t.i. d., amoxicillin 500 mg PO q.i.d., both for 2 weeks and bismuth subcitr ate colloidal 120 mg PO q.i.d. for 4 weeks, in addition to ranitidine 300 mg PO at night for 6 weeks. Eradication of H.pylori was defined as absence of the organism in both histology and culture 6 weeks after c ompleting triple therapy. H.pylori susceptibility was performed using the disc diffusion method. Results: forty-nine patients; 38 males, mea n age 41.4(11) years and 11 females, mean age 40.3(15) years were incl uded. Eighty-four percent of peptic ulcers had healed by the end of th e study period. However, only 49% of H.pylori was successfully eradica ted. Overall metronidazole resistance was encountered in 45.7% of H.py lori isolate. Females harbored resistant strains more frequently than males, 77.8% versus 34.6%, respectively (p=0.03). Conclusions: Metroni dazole based triple therapy has a low success rate which is most likel y secondary to H.pylori resistance.