Comparison of 1-week and 2-week triple therapy with omeprazole, amoxicillin, and clarithromycin in peptic ulcer patients with Helicobacter pylori infection: results of a randomized controlled trial

This study was a comparison of 1-week and 2-week triple therapies with omep razole, amoxicillin, and clarithromycin (OAC) in patients with peptic ulcer disease and helicobacter pylori infection. A total of 147 peptic ulcer pat ients with H. pylori infection assessed by histology and culture were rando mly treated with omeprazole 20mg bid + amoxicillin 1000mg bid + clarithromy cin 400mg bid for either 1 week (OAC1w) or 2 weeks (OAC2w). Both groups the n received omeprazole 20mg daily for 2 weeks followed by ranitidine 300mg d aily for 4 weeks. Eradication of Ii. pylori was assessed by histology, cult ure, and the C-13-urea breath test (C-13-UBT) at least 4 weeks after cessat ion of antimicrobial therapy. Intention-to-treat eradication rates were 78. 2% (95%CI69%-87%) with OAC1w and 88.4% (95%CI81%-96%) with OAC2w. Per-proto col eradication rates were 86.0% (95%CI78%-94%) with OAC1w, 97.0% (95%CI93% -100%) with OAC2w. There was no significant difference in the eradication r ates between QAC1w and OAC2w, Side effects were mild and self-limiting in b oth groups. In conclusion, both 1- and 2-week triple therapy with OAC are w ell tolerated and provide good eradication rates in peptic ulcer patients i n Japan. The eradication rate of the 2-week regimen was higher than that of the 1-week regimen, but the difference was not statistically significant. Further studies including long-term economic considerations are required to determine the optimal duration of treatment.