Is 1-week treatment for peptic ulcer healing sufficient and safe?

OBJECTIVE: to confirm whether 1-week anti-Helicobacter therapy to achieve u lcer healing is sufficient and safe. METHODS: We retrospectively analyzed patients with peptic ulcer who were in fected with Helicobacter pylori and treated with 3 different 7-day regimens , according to predefined protocols in 3 different centers in the same geog raphical area (Aragon, Spain). Three combinations commonly described in the literature were used: a) omeprazole (40 mg/24 h), tetracycline hydrochlori de (2 g/24 h), colloidal bismuth subcitrate (480 mg/24 h) and metronidazole (750 mg/24 h) (OBTM, n = 105); b) omeprazole (40 mg/24 h), clarithromycin (1 g/24 h) and amoxicillin (3 g/24 h) (O(40)C(1.5)A(3), n = 13); and c) ome prazole (40 mg/24 h), clarithromycin (1.5 g/24 h) and amoxicillin (2 g/24 h ) (O(40)C(1)A(2), n = 4). In all patients the diagnosis of peptic ulcer dis ease was confirmed endoscopically, and H. pylori infection was verified wit h urease testing and histological analysis. After treatment ended, no other antacids were allowed until after endoscopic examination to check eradicat ion and ulcer healing. RESULTS: 122 patients were included (107 with duodenal ulcer, 12 with gastr ic ulcer and 3 with both). Compliance was good and side effects infrequent and mild. Eradication rates were 88.5% (93/105) in the OBTM group, 100% (13 /13) with O(40)C(1.5)A(3), and 75% (3/4) with O(40)C(1)A(2). Healing was ac hieved in 98.16% (107/109) of the patients in whom the bacterial infection was eradicated, and in 23.07% (3/13) of those in whom it was not (p < 0.000 1). No patient had any complications during the period without treatment. CONCLUSIONS: 1-week eradication therapy with previously described combinati ons commonly used in clinical practice achieves high ulcer healing rates wi th no complications in the period without antacid treatment. We consider th at it is not necessary, at least in most patients, to prolong antacid thera py.