Short report: omeprazole-tetracycline combinations are inadequate as therapy for Helicobacter pylori infection.
BACKGROUND
Current triple antimicrobial therapies cure Helicobacter pylori infection in 60-90% of cases but are cumbersome. Addition of omeprazole to amoxycillin has been shown to enhance effectiveness when compared to amoxycillin alone.


METHODS
We studied omeprazole 20 mg t.d.s. plus tetracycline 500 mg q.d.s. for 14 days (OMP/TCN) and omeprazole 40 mg in the morning plus tetracycline 500 mg q.d.s. along with bismuth subsalicylate tablets 2 q.d.s. (OMP/TCN/BSS) for 14 days. Forty-four patients (19 OMP/TCN, 25 OMP/TCN/BSS) with H. pylori peptic ulcer disease were studied. H. pylori status was evaluated at least 4 weeks after ending antimicrobial therapy.


RESULTS
In the OMP/TCN group cure of H. pylori infection was achieved in 5/19 (26%). Adding bismuth to the regimen improved the results; 4 weeks after ending therapy cure of H. pylori infection was achieved in 12/25 (48%).


CONCLUSIONS
Neither regimen can be recommended for routine cure of H. pylori infection. Although one cannot predict which antimicrobial therapies will be enhanced by the addition of omeprazole, these data suggest that future studies should evaluate drugs whose effectiveness is compromised by low pH.
al-Assi
M T
MT
Department of Medicine, Veterans Affairs Medical Center, Houston, Texas 77030.
Genta
R M
RM
Graham
D Y
DY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001729:Bismuth / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology; D013276:Stomach Ulcer / Q000188:drug therapy; D013752:Tetracycline / Q000008:administration & dosage*
D013752:Tetracycline; D009853:Omeprazole; D001729:Bismuth