title: Amoxycillin capsules with omeprazole for the eradication of Helicobacter pylori. Assessment of the importance of antibiotic dose timing in relation to meals.
abstract: BACKGROUND
  Giving antibiotics after meals prolongs their gastric residence time and improves their intragastric distribution. We aimed to see whether this would result in improved eradication of Helicobacter pylori.
  
  
  METHODS
  Eighty patients with H. pylori infection were treated with 40 mg omeprazole in the morning for 28 days and amoxycillin 500 mg q.d.s. for days 15-28. Amoxycillin dosing was randomised to either 1 h before or 10 min after food. Good compliance was pre-defined as missing less than four doses of amoxycillin or two of omeprazole.
  
  
  RESULTS
  Amoxycillin dosing after meals was shown not to affect H. pylori eradication rate either when results were analysed on an intention-to-treat basis [amoxycillin before meals successful in 63% (25/40), after in 65% 26/40)] or for good compliers only [before meals 81% (17/21), after 71% (20/28)]. This excludes, with 95% confidence, a benefit of greater than 18% from dosing before, or 23% from dosing after meals. Good compliance, however, was shown to be important, with H. pylori eradication in 76% (37/49) of good compliers compared with 48% (11/23) of others completing the protocol (P < 0.05).
  
  
  CONCLUSIONS
  The timing of antibiotic administration in relation to meals is not important in the treatment of H. pylori infection with this regimen of amoxycillin capsules and omeprazole. Good compliance, is however, an important determinant of treatment success.
authors.affiliation: Division of Gastroenterology, University Hospital, Queen's Medical Centre, Nottingham, UK.
authors.forename: J C
authors.initials: JC
authors.lastname: Atherton
authors.forename: N
authors.initials: N
authors.lastname: Hudson
authors.forename: G E
authors.initials: GE
authors.lastname: Kirk
authors.forename: C K
authors.initials: CK
authors.lastname: Hawkey
authors.forename: R C
authors.initials: RC
authors.lastname: Spiller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000382:microbiology; D004435:Eating / Q000502:physiology*; D005260:Female; D005502:Food; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000378:metabolism; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage* / Q000009:adverse effects; D013276:Stomach Ulcer / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000658:Amoxicillin; D009853:Omeprazole