Two-year follow-up of duodenal ulcer patients treated with omeprazole and amoxicillin.
The present study evaluated the time in remission during a 2-year follow-up after eradication of Helicobacter pylori (HP) in patients with an HP-associated duodenal ulcer (DU). HP was eradicated by combined treatment with high-dose omeprazole (2 x 40 mg) and amoxicillin (2 x 1,000 mg; n = 27) administered for 10 days (OME + AMX); alternatively, patients were treated with omeprazole monotherapy (OME) using the same dosage (n = 25). During the 2-year follow-up period endoscopy including histological examination was performed after 1 and 2 years or whenever symptoms compatible with ulcer relapse occurred. HP eradication was achieved in 82% of the OME + AMX group, but in 0% of the OME group. The cumulative DU relapse rates were 0% after 1 year and 7% after 2 years in 22 patients who became HP-negative. Both HP-negative patients who relapsed in the 2nd year of follow-up were HP-positive again at the time of relapse. Of the 5 patients who were not eradicated after OME + AMX therapy, 2 relapsed within the 1st year (40%) and another 2 within the 2nd year (80%). In the OME group the cumulative relapse rates within 1 and 2 years of follow-up were 52 and 76%, respectively. The results further confirm that eradication of HP with combined OME + AMX treatment leads to a distinct decrease in DU relapse rates and thus may cure DU disease. Long-term eradication with combined OME + AMX treatment is possible, and the rate of reinfection with HP is low (4.5%/year).
Miehlke
S
S
Department of Internal Medicine II, Klinikum Grosshadern, University of Munich, Germany.
Bayerdörffer
E
E
Lehn
N
N
Mannes
G A
GA
Sommer
A
A
Höchter
W
W
Weingart
J
J
Hatz
R
R
Ruckdeschel
G
G
Dirschedl
P
P
D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000517:prevention & control; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use*; D012008:Recurrence; D013997:Time Factors
D000658:Amoxicillin; D009853:Omeprazole