Short-term therapy with azithromycin, amoxycilin and omeprazole for the eradication of Helicobacter pylori

Background: the high cost and complexity of therapeutic schemes for the era dication of Helicobacter pylori has stimulated the search of simpler and ch eaper treatment options. Aim: To evaluate the efficacy of 3 days of azithro mycin 500 mg od, 7 days of amoxycilin 750 mg tid and omeprazole, 20 (Group A) or 40 mg (Group B) on randomization, as a treatment for Helicobacter pyl ori infection in patients with endoscopically diagnosed peptic ulcer. Metho ds: H. pylori status of peptic ulcer patients was pathologically confirmed by the examination of five gastric biopsies using the Giemsa stain and by r apid urease testing in two gastric biopsies. H. pylori status was reassesse d not less than 28 days after completing treatment. Adverse events and comp liance were evaluated. Results: Fifty four patients (29 men, 25 women, mean age 48 years) were enrolled, 28 in Group A and 27 in Group B. Per protocol the infection was cured in 58,8% of patients (30/51; 95% CI: 45-73%). On a n intention to treat basis, H pylori infection was cured in 55%. Minor side effects including diarrhea and nausea were reported by 32% of patients. Ni nety five per cent of patients consumed more than 95% of prescribed medicat ions. H. pylori was successfully erradicated in 61% of group A and 57% of g roup B patients (p = NS). Conclusion: Short term therapy with azithromycin was poorly effective in curing H. pylori infection. The compliance was exce llent. Increasing Omeprazole from 30 to 40 mg/day did not improve treatment effectiveness.