This paper is only available as a PDF. To read, Please Download here.
Omeprazole combined with 2 antimicrobials has been suggested as a first-line option for Helicobacter pylori eradication in recent years. However, controversy exists regarding the efficacy of this protocol. This open-label, prospective clinical study investigated the efficacy of omeprazolebased triple therapy for H pylori eradication in 518 patients with H pylori-positive functional dyspepsia with or without duodenal ulcer. Amoxicillin, macrolides (clarithromycin or roxithromycin), and nitroimidazoles (metronidazole, ornidazole, or tintdazole) were the antibiotics used in the study. Nonulcer patients were randomly assigned to 1 of 8 different treatment protocols anu duodenal ulcer patients were randomly assigned to 1 of 4 different treatment protocols consisting of omeprazole (20 mg once daily for nonulcer patients, 20 mg twice daily for ulcer patients for 14 days) with a combination of 2 of the above antimicrobials (for 10 days). H pylori infection was assessed by histologic findings and a rapid urease test before therapy and 4 weeks after therapy ended. Four hundred fifty-nine patients completed their regimens; 327 had functional dyspepsia (180 men, 147 women; median age, 39 years; range, 18 to 70 years) and 132 had ulcers (81 men, 51 women; median age, 40 years; range, 18 to 70 years). Eradication of H pylori was achieved in 58.8% (270 of 459) of all patients, 58.1% (190 of 327) of nonulcer dyspeptic patients, and 60.6% (80 of 132) of duodenal ulcer patients. The eradication rate varied from 47.2% to 69.4% in different treatment protocols. There were no statistically significant differences in eradication rates in any treatment group. All drugs were generally well tolerated in all groups, and no patient discontinued treatment because of side effects. Therapy witn omeprazole and 2 antimicrobials for H pylori had limited efficacy in a Turkish population. The reason for these results, which conflict with those of other studies, is not clear. Further investigations of regimens for the eradication of H pylori in our population are necessary.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Clinical Therapeutics
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Helicobacter pylori in peptic ulcer disease. NIH Consensus Development Panel on Helicobacter pylori in Peptic Ulcer Disease.JAMA. 1994; 272: 65-69
- Treatment of peptic ulcers caused by Helicobacter pylori.N Engl J Med. 1993; 328: 349-350
- Do Helicobacter pylori-positive duodenal ulcers have an increased risk of bleeding?.Am J Gastroenterol. 1995; 90 (Letter): 1901
- Role of Helicobacter pylori eradication in the prevention of peptic ulcer bleeding relapse.Digestion. 1994; 55: 19-23
- Drug therapy for Helicobacter pylori infection: Problems and pitfalls.Am J Gastroenterol. 1990; 85: 1545-1551
- Meta-analysis of the efficacy of antibiotic therapy in eradicating Helicobacter pylori.Am J Gastroenterol. 1992; 87: 1716-1727
- Factors influencing the eradication of Helicobacter pylori with triple therapy.Gastroenterology. 1992; 102: 493-496
- Medium-or high-dose omeprazole plus amoxicillin eradicates Helicobacter pylori in gastric ulcer disease.Am J Gastroenterol. 1994; 89: 726-730
- Low eradication rates of Helicobacter pylori with omeprazole plus amoxycillin combination in a Turkish population.Am J Gastroenterol. 1996; 91 (Letter): 1062
- Treatment of Helicobacter pylori infection: A review of the world liter-ature.Helicobacter. 1996; 1: 6-19
- Treatment of Helicobacter pylori infection.Curr Opin Gastroenterol. 1997; 13: 56-62
- Oneweek triple therapy with omeprazole, amoxycillin and either clarithromycin or metronidazole for cure of Helicobacter pylori infection.Aliment Pharmacol Ther. 1996; 10: 207-210
- One-week low-dose triple therapy: New standards for Helicobacter pylori treatment..Eur J Gastroenterol Hepatol. 1995; 7: 1-3.
- Eradication of Helicobacter pylori using one-week triple therapies combining omeprazole with two antimicrobials. The MACH l Study.Helicobacter. 1996; 1: 138-144
- Effect of omeprazole on duodenal ulcer-associated antral gastritis and Helicobacter pylori.Dig Dis Sci. 1991; 36: 577-582
- The treatment of Helicobacter pylori infection in the management of peptic ulcer disease.N Engl J Med. 1995; 333: 984-991
- Susceptibility of Campylobacter pylori to macrolides and fluoroquinolones.J Antimicrob Chemother. 1988; 22: 631-636
- Eradication of Helicobacter pylori and prevention of recurrence of duodenal ulcer: A randomized, double-blind, multicentre trial of omeprazole with or without clarithromycin.Aliment Pharmacol Ther. 1995; 9: 417-423
- Overview of the tolerability profile of clarithromycin in preclinical and clinical trials.Drug Saf. 1993; 8: 350-354
- Clarithromycin as monotherapy for eradication of Helicobacter pylori: A randomized double-blind trial.Am J Gas-troenterol. 1993; 88: 1860-1864
- (Abstract)Short course of roxithromycin, nitroimidazine and omeprazole therapy for the eradication of Helicobacter pylori.in: Presented at the Digestive Disease Week and the 96th Annual Meeting of the American Gas- troenterological Association, May 19–22, 1996; San Francisco, CaliforniaGastroenterology. 110. 1996: A259
- Synergic interactions of macrolides and protonpump inhibitors against Helicobacter pylori: A comparative in-vitro study.J Antimicrob Chemother. 1998; 41: 29-35
- In vitro susceptibility of Helicobacter pylori to several antimicrobial combinations.Antimicrob Agents Chemother. 1993; 37: 1184-1186
- The treatment of Helicobacter pylori infection.Aliment Pharmacol Ther. 1997; 11: 35-41
- Impact of metronidazole resistance on the eradication of Helicobacter pylori.Scand J Infect Dis. 1994; 26: 321-327
- Resistance of Helicobacter pylori to antibiotics.Aliment Pharmacol Ther. 1997; 11: 45-53
- Current European concepts in the management of Helicobacter pylori infection—the Maastricht Consensus Report. The European Helicobacter pylori Study Group (EHPSG).Eur J Gastroenterol Hepatol. 1997; 9: 1-2
- The susceptibility of Helicobacter pylori to vari-ous antibiotics.Turk J Gastroenterol. 1996; 7 (Abstract. In Turkish): B55
Accepted: July 15, 1999
© 1999 Published by Elsevier Inc.