Comparison of seven and fourteen days of lansoprazole, clarithromycin, andamoxicillin therapy for eradication of Helicobacter pylori: A report from India

Background. In developed countries, a 1-week regimen of combined proton pum p inhibitors and two antibiotics is considered adequate for Helicobacter py lori eradication. However, there is a paucity of reports from developing co untries on treatment duration of less than 14 days. We compared efficacy of 7 and 14 days of lansoprazole it), clarithromycin (C), and amoxicillin (A) combinations for eradication of H. pylori. Patients and Methods. Forty-six consecutive patients who presented with upp er gastrointestinal symptoms and tested positive for H. pylori infection we re included in the study. In every patient, after performance of upper gast rointestinal endoscopy, antral biopsies were obtained. H. pylori infection was diagnosed by positive rapid urease test and identification of organisms on antral histology. Patients were randomly selected to receive lansoprazo le, 30 mg once daily, plus clarithromycin, 250 mg twice daily, plus amoxici llin, 500 mg three times daily for 2 weeks (group 1; n = 24; age, 36 +/- 12 years; 18 men) or 1 week (group 2; n = 22; age, 45 +/- 15 years; 12 men). One month after completion of treatment, repeat upper gastrointestinal endo scopy was performed. H. pylori eradication was defined as absence of organi sm on histopathological examination of both antrum and body of stomach and negative rapid urease test. Results. Eradication rate was higher in group 1 (23 of 24; 96%) as compared to group 2 (12 of 22; 54%; p <.05). One patient in group 1 had diarrhea, a nd one patient in group two had skin rash and itching. Conclusions. Fourteen-day therapy with lansoprazole, clarithromycin, and am oxicillin is highly effective in eradication of H. pylori. Reducing duratio n of therapy to 7 days significantly lowers eradication rates.