Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori.
100 consecutive patients with both duodenal ulcer and Campylobacter pylori infection were followed up to see whether eradication of C pylori affected ulcer healing or relapse. Patients were randomly assigned to 8 weeks of treatment with cimetidine or colloidal bismuth subcitrate (CBS), with tinidazole or placebo being given concurrently from days 1 to 10, inclusive. Endoscopy, biopsy, and culture were done at entry, in weeks 10, 22, 34, and 62, and whenever symptoms recurred. There was no maintenance therapy. C pylori persisted in all of the cimetidine-treated patients and in 95% of those treated with cimetidine/tinidazole, but was eradicated in 27% of the CBS/placebo group and 70% of the CBS/tinidazole group. When C pylori persisted, 61% of duodenal ulcers healed and 84% relapsed. When C pylori was cleared 92% of ulcers healed (p less than 0.001) and only 21% relapsed during the 12 month follow-up period (p less than 0.0001).
Marshall
B J
BJ
Department of Gastroenterology, Royal Perth Hospital, Western Australia.
Goodwin
C S
CS
Warren
J R
JR
Murray
R
R
Blincow
E D
ED
Blackbourn
S J
SJ
Phillips
M
M
Waters
T E
TE
Sanderson
C R
CR
D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D002167:Campylobacter / Q000302:isolation & purification; D002169:Campylobacter Infections / Q000150:complications / Q000188:drug therapy*; D002927:Cimetidine / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology; D005756:Gastritis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use; D011446:Prospective Studies; D012008:Recurrence; D014011:Tinidazole / Q000627:therapeutic use
D000897:Anti-Ulcer Agents; D009942:Organometallic Compounds; D014011:Tinidazole; D002927:Cimetidine; C002791:bismuth tripotassium dicitrate