[Comparison of the efficacy of omeprazole/bismuth subcitrate or triple therapy in Helicobacter pylori gastritis. A prospective controlled study].
In a controlled, prospective, randomized trial, 10 patients with Helicobacter pylori positive gastritis were treated either with triple therapy (tetracycline, ornidazole, bismuth subcitrate; T, Or, CBS), or omeprazole/CBS (O/CBS) to test the eradication rate of each treatment, its effect on gastritis and meal stimulated gastrin release.


METHODS
6 patients were treated with triple therapy and 4 patients with O/CBS for 2 weeks. Initially, and 0.5, 1, 3, 6, and 12 months after therapy, patients were investigated by a highly specific, quantitative Helicobacter serology, 13C-urea breath test and measurement of meal-stimulated gastrin release. After 3 and 12 months antral biopsies were taken endoscopically for rapid urease testing and culture. Activity of histological gastritis was graded.


RESULTS
Eradication for at least 12 months was achieved in 5 out of 6 patients with triple therapy. Serology normalized and gastritis activity improved. In all patients treated with O/CBS, HP was suppressed only temporarily. No eradication was achieved. Urease testing and histology proved to be reliable tests for detecting HP. Culturing of HP was successful in only 66% due to technical problems. The 13C-urea breath test was correct in all cases. The initially, increased meal-stimulated gastrin release was normalized after eradication of HP.


CONCLUSIONS
(1) Triple therapy is also successful in short term treatment in up to 80% of patients with HP gastritis and improves gastritis activity. (2) The combination O/CBS failed to eradicate HP in all treated patients. (3) The 13C-urea breath test and HP serology are reliable non-invasive parameters during follow-up. (4) Normalization of meal stimulated gastrin release after eradication of HP supports the hypothesis that HP induces increased gastrin release and hyperacidity.
Bertschinger
P
P
Departement für Innere Medizin, Universitätsspital Zürich.
Brunner
J
J
Flury
R
R
Lammer
F
F
Jost
R
R
Häcki
W H
WH
D000863:Antacids / Q000008:administration & dosage; D001944:Breath Tests; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D005260:Female; D005756:Gastritis / Q000188:drug therapy* / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D009942:Organometallic Compounds / Q000008:administration & dosage*; D009950:Ornidazole / Q000008:administration & dosage; D011446:Prospective Studies; D013752:Tetracycline / Q000008:administration & dosage; D014508:Urea / Q000032:analysis
D000863:Antacids; D009942:Organometallic Compounds; D009950:Ornidazole; D014508:Urea; D013752:Tetracycline; C002791:bismuth tripotassium dicitrate; D009853:Omeprazole
Vergleich der Wirksamkeit von Omeprazol/Bismutsubcitrat oder Tripletherapie bei Helicobacter-pylori-Gastritis. Eine prospektive kontrollierte Studie.