[The effect of "triple therapy" on the eradicating of H. pylori and the healing of a duodenal ulcer. The initial study and 6 months later].
Helicobacter pylori plays an important role in the pathogenesis of peptic ulcer disease, and many therapy regimens have been used to eradicate it.


OBJECTIVE
To assess the efficacy of triple therapy in duodenal ulcer patients, in ulcer healing and eradication of H. pylori, early after treatment and 6 months later.


METHODS
In a prospective study, 32 patients with duodenal ulcer disease and H. pylori infection were studied. Biopsy specimens from the duodenal bulb, antrum, body and gastric fundus were taken and were analyzed by a microbiology (Gram and specific culture) and histology process (hematoxylin and eosin). All patients were treated with triple therapy (bismuth, tetracyclin and metronidazole). Patients were investigated endoscopically one month after cessation the triple therapy and 4 months later, with taking of antrum and body biopsy specimens.


RESULTS
During the therapy, adverse events were elucidated in 3 patients (9.4%). Eradication (no evidence on ongoing H. pylori infection 4 wk after cessation treatment) was obtained in 26 patients (81.25%). Eradication reached 92% when H. pylori was metronidazole sensitive (N:25; 78.13%) and 42.86% (p < 0.05) when it was resistant. Reinfection rate was 3.85% (N = 1). Healing ulcer was observed in 28 patients (87.5%) 1 month after cessation of treatment. When triple therapy regimen was successful the healing rate was 96.15%, and it was 50% (p < 0.05) when it failed.


CONCLUSIONS
Triple therapy (with low doses of metronidazole, and tetracyclins) has a high efficacy (81.25%) in the eradication of H. pylori (metronidazole sensitivity plays an important role), with few (9.4%) and non-serious adverse events. Healing rate is 96.15% when eradication is obtained and 50% (p < 0.05) when it failed.
Gisbert
J P
JP
Hospital Ramón y Cajal, Departamento de Medicina, Universidad de Alcalá de Henares, Madrid.
Boixeda
D
D
de Rafael
L
L
Martín de Argila
C
C
Bermejo
F
F
García Plaza
A
A
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction; D013752:Tetracycline / Q000008:administration & dosage; D013997:Time Factors
D000897:Anti-Ulcer Agents; D009942:Organometallic Compounds; D008795:Metronidazole; D013752:Tetracycline; C002791:bismuth tripotassium dicitrate
Efecto de la "triple terapia" sobre la erradicación de H. pylori y la cicatrización de la úlcera duodenal. Estudio inicial y a los 6 meses.