ERADICATION OF HELICOBACTER-PYLORI IN PEPTIC-ULCER DISEASE WITH AMOXICILLIN, 2.0G, AND OMEPRAZOLE, 80 OR 120 MG - A PROSPECTIVE RANDOMIZED TRIAL

Background: The appropriate dose of proton pump inhibitors needed for eradicating Helicobacter pylori by dual therapy is still controversial . Design: The study was conducted as a single-blind, single-centre tri al. Methods: Fifty-four patients with active duodenal ulcers were trea ted with amoxycillin tablets, 750 mg three times daily, and omeprazole , either 40 mg twice daily (group 1) or 40 mg three times daily (group 2), for 14 days in a prospective randomized trial. H. pylori eradicat ion was assessed 10 weeks after starting treatment. Biopsies were take n for rapid urease tests and histological analysis and C-13-urea breat h tests were ordered. Results: In both groups ulcer healing was comple te in 96.3% of patients after 10 weeks. Ten weeks after starting treat ment, Helicobacter pylori was eradicated in 76.9% of the patients in g roup 1 and 74.1% of those in group 2, as shown by rapid urease tests a nd histological analysis. In the subgroup of fully compliant patients (n=49) the eradication rates were 80% and 79.2%, respectively. Hyperac idity significantly reduced the eradication rates. Patients showing su ccessful H. pylori eradication were significantly older (59 +/- 14.0 y ears vs. 49 +/- 15.6 years; P=0.025). Eradication rates were lower in smokers than in non-smokers (36.4% vs. 83.9%; P=0.006). Conclusion: It is concluded that higher omeprazole doses should be reserved for youn ger patients and smokers; in others they are not needed.