Efficacy of a 1-week pantoprazole triple therapy in eradicating Helicobacter pylori in Asian patients

Background: The aim of the present paper was to determine the efficacy and tolerability of a 1-week treatment regimen consisting of pantoprazole and t wo antibiotics: clarithromycin and amoxycillin, in the eradication of Helic obacter pylori. Methods: The patients selected had unequivocal evidence of H. pylori infect ion based on urease test, culture and histology on antral and corpus biopsi es obtained at endoscopy. Patients received pantoprazole 40 mg twice a day, clarithromycin 500 mg twice a day and amoxycillin 1 g twice a day for 1 we ek and were assessed for successful eradication at least 4 weeks after comp letion of therapy by repeat gastroscopy and gastric biopsies. Eradication w as defined as absence of bacteria in both antral and corpus biopsies tested by culture, histology and urease test. Results: One hundred and six patients were recruited for the study. The mea n age was 48.0 years (range: 23-74 years). Four patients defaulted follow u p and five patients were not compliant (taking less than 85%) with medicati ons. Eradication rates on per-protocol analysis were: 88/97 (90.7%; 95% CI: 83.1-95.7); and on intention-to-treat analysis they were: 88/106 (83.0%; 9 5% CI: 75.9-90.2). Side-effects were in general mild and tolerable: 57 of 1 06 (53.7%) patients complained of a bitter taste; 15 (14.1%) complained of giddiness; 10 (9.4%) complained of increased abdominal pain; 11 (11.5%) com plained of lethargy and 16 (15.1%) complained of loose motions. Pre-treatme nt metronidazole resistance was encountered in 57/74 strains (77.0%). Clari thromycin resistance was not encountered in any of the strains. Conclusions: The pantoprazole 1-week triple therapy with amoxycillin and cl arithromycin is effective in H. pylori eradication. The treatment was well tolerated by patients. Metronidazole resistance was reported in a high perc entage of strains isolated from patients. Clarithromycin resistance was, ho wever, nor, detected in any of the strains. (C) 2000 Blackwell Science Asia Pty Ltd.