AN INCREASING DOSE OF OMEPRAZOLE COMBINED WITH AMOXICILLIN CURES HELICOBACTER-PYLORI INFECTION MORE EFFECTIVELY

Background: The combination of omeprazole and amoxycillin has demonstr ated effectiveness with very few side-effects in the treatment of H. p ylori infection, however cure rates have varied widely. The present st udy addresses the question as to the extent to which the cure rate of H. pylori infection depends on the size of the daily omeprazole dose, and investigates other patient-related factors that influence treatmen t success. Methods: In a randomized, controlled and investigator-blind ed trial, 163 hospitalized patients with H. pylori-associated gastriti s were treated with 20 mg omeprazole once daily in the morning, 20 mg omeprazole b.d., 40 mg omeprazole b.d. or 60 mg omeprazole b.d. for 14 days. In addition, all patients received 1000 mg amoxycillin b.d. on days 5-14, Endoscopic and histological examinations were performed pri or to treatment, at the end of treatment and 4 weeks after completion of treatment. Results: H. pylori infection was cured in 18 of 40 (45%, 95% CI: 29-62%), in 22 of 39 (56.4%, 95% CI: 40-72%), in 25 of 38 (65 .8%, 95% CI: 49-80%), and in 33 of 40 (82.5%, 95% CI: 67-93%) patients , respectively, (P < 0.001). Side-effects leading to discontinuation o f treatment occurred in only 1.2%. Conclusion: The daily dose of omepr azole is an important factor for the success of dual therapy comprisin g omeprazole and amoxycillin in curing H. pylori infection, Cure of H. pylori infection correlates positively and significantly with the siz e of the daily omeprazole dose, The combination of high-dose omeprazol e and amoxycillin is an effective and well-tolerated regimen for the t reatment of H. pylori-associated diseases.