RANDOMIZED STUDY COMPARING OMEPRAZOLE PLUS AMOXICILLIN VERSUS OMEPRAZOLE PLUS CLARITHROMYCIN FOR ERADICATION OF HELICOBACTER-PYLORI

Background: Dual therapy with omeprazole plus amoxycillin or with omep razole plus clarithromycin has been proposed for eradication of Helico bacter pylori. The main problem is the great variability in the rate o f eradication, Methods: A group of 287 consecutive patients with activ e peptic ulcers and H. pylori infections were admitted to a prospectiv e, randomized, multicentre study, to be given omeprazole 20 mg b.d. pl us either amoxycillin 1 g b.d, or clarithromycin 500 mg t.d.s. for 2 w eeks. Cure was defined as the absence of H. pylori infection, 4-6 week s after completing anti-microbial therapy, assessed by urease activity and histology of antral and body gastric biopsies. Results: The bacte ria were eradicated in 68/143 patients (48%) treated with amoxycillin and omeprazole and 70/144 patients (49%) treated with clarithromycin a nd omeprazole (intention-to-treat analysis), The ulcers were healed in 118/127 patients (93%) treated with amoxycillin and in 115/123 (94%) of those treated with clarithromycin, Undesirable effects were rare wi th both treatments, Conclusions: Combined treatment with omeprazole pl us either amoxycillin or clarithromycin produced a high percentage of short-term healing of ulcers and was well tolerated, but is not useful as first-line anti-Helicobacter pylori treatment.