Dual versus triple therapy in eradication of Helicobacter pylori

• Background/Aims: Duodenal ulcers should be treated by eradication of Helicobacter pylori. This study compared the efficacy of a proton pump inhibitor together with one or two antibiotics in eradication therapy, Methodology: 177 patients who were H. pylori positive were randomized to receive 14 days of either: lansoprazole 30mg bd and amoxicillin 1g bd (LA), omeprazole 20mg bd and amoxicillin 1g bd (OA) or lansoprazole 30mg bd, amoxicillin 1g bd and clarithromycin 500mg bd (LAC). The efficacy was assessed at four weeks and at six months after the end of treatment. Biopsies were taken for culture and bacterial sensitivity testing at inclusion and at four weeks after the end of treatment. Results: 149 patients were evaluated for efficacy. The eradication rate was significantly higher in LAC (96%) compared to LA (51%) and OA (64%) treatments (P<0.001). At baseline 17%, 21% and 19% of the patients in the LA, OA and LAC groups, respectively, were resistant to metronidazole and only one patient was resistant to clarithromycin. Post-treatment, four patients had acquired metronidazole resistance. Conclusions: LAC is more effective than LA and CA for eradication of H. pylori in duodenal ulcer disease.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

triple therapy

duodenal ulcer

H. pylori infection

eradication therapy

Publikations- och innehållstyp

art (ämneskategori)

ref (ämneskategori)