Pantoprazole suppresses Helicobacter pylori without affecting cure

Background. Short-term, low-dose triple regimens composed of proton-pump in hibitors (PPI) and two antibiotics are the current gold standard therapy fo r cure of Helicobacter pylori infection. To date, the effect of PPI pretrea tment on eradication outcome is not known. The aim of this study was to eva luate the influence of pretreatment with pantoprazole on the efficacy of an ensuing triple therapy. Methods. In this open, randomized, monocenter, parallel group comparison, 1 07 patients with duodenal ulcer or functional dyspepsia were assigned to re ceive one of the following treatment regimens: a 7-day triple therapy with pantoprazole, 40 mg bid; clarithromycin, 250 mg bid; and metronidazole, 400 mg bid, which was either preceded or followed by a 7-day therapy with pant oprazole, 40 mg (P-PCM or PCM-P). Assessment of H. pylori status was perfor med by a biopsy urease test and C-13 urea breath test at the initial visit and C-13 urea breath test at all follow-up visits. Results. The 7-day pantoprazole pretreatment resulted in a significant decl ine of the delta values of the C-13 urea breath test. H. pylori infection w as cured in 47 of 52 intention-to-treat patients of the P-PCM group (90%; 9 5% confidence interval, 79-97%) and in 46 of 53 of the PCM-P group (87%; 95 %:, confidence interval, 75-95%). Conclusions. Pretreatment with pantoprazole suppresses H. pylori but does n ot impair the efficacy of a consecutive short-term, low-dose triple therapy .