Fish oil (Eicosapen) is less effective than metronidazole, in combination with pantoprazole and clarithromycin, for Helicobacter pylori eradication

Background: In vitro omega -3-fatty acids (Eicosapen) are bacteriostatic to Helicobacter pylori and have a variety of immuno-modulating effects. Aim: To investigate the efficacy and tolerability of eicosapen (E) as an an tibiotic-sparing component of a triple H. pylori eradication regimen in non -ulcer dyspepsia patients in a randomized, double-blind trial. Methods: Non-ulcer dyspepsia patients (n=199), with a normal upper endoscop y and a positive C-13-urea breath test (UBT) were randomly assigned to eith er pantoprazole, clarithromycin and metronidazole (PCM) or pantoprazole, cl arithromycin and eicosapen (PCE) for 7 days. Four weeks after treatment, H. pylori eradication was determined by UBT. Symptoms were followed up to 16 months. Results: In the intention-to-treat population, PCM eradicated infection in 78% but PCE was successful in only 34% (P < 0.001). Symptomatic improvement occurred in both groups, and was not related to H. pylori eradication. Conclusion: Eicosapen is unlikely to be useful in H. pylori eradication reg imens.