Randomised controlled trial of short term treatment to eradicate Helicobacter pylori in patients with duodenal ulcer.
OBJECTIVE
To determine whether one week's drug treatment is sufficient to eradicate Helicobacter pylori in patients with duodenal ulcer.


METHODS
Single blind, randomised controlled trial.


METHODS
Specialised ulcer clinic in a teaching hospital.


METHODS
155 patients with H pylori and a duodenal ulcer verified endoscopically which had either bled within the previous 24 hours or was causing dyspepsia.


METHODS
Patients were allocated randomly to receive either omeprazole for four weeks plus bismuth 120 mg, tetracycline 500 mg, and metronidazole 400 mg (all four times a day) for the first week (n = 78), or omeprazole alone for four weeks (n = 77). Further endoscopy was performed four weeks after cessation of all drugs.


METHODS
Presence or absence of H pylori (by urease testing, microscopy, and culture of antral biopsy specimens), duodenal ulcer, and side effects.


RESULTS
Eradication of H pylori occurred in 70 (95%) patients taking the four drugs (95% confidence interval 86% to 97%) compared with three (4%) patients taking omeprazole alone (1% to 11%). Duodenal ulcers were found in four (5%) patients taking the four drugs (2% to 12%) and in 16 (22%) patients taking omeprazole alone (14% to 32%). Mild dizziness was the only reported side effect (six patients in each group) and did not affect compliance.


CONCLUSIONS
A one week regimen of bismuth, tetracycline, and metronidazole is safe and effective in eradicating H pylori and reduces the number of duodenal ulcers four weeks after completing treatment.
Hosking
S W
SW
Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong.
Ling
T K
TK
Yung
M Y
MY
Cheng
A
A
Chung
S C
SC
Leung
J W
JW
Li
A K
AK
D001729:Bismuth / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D004386:Duodenum / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use*; D009853:Omeprazole / Q000627:therapeutic use*; D016037:Single-Blind Method; D013752:Tetracycline / Q000627:therapeutic use*
D008795:Metronidazole; D013752:Tetracycline; D009853:Omeprazole; D001729:Bismuth