Follow-up on 242 patients with peptic ulcer disease one year after eradication of Helicobacter pylori infection.
OBJECTIVE
From Dec. 1990 to Jan. 1993 we treated 306 patients with chronic peptic ulcer disease and gastric Helicobacter pylori infection with one of three triple therapy regimens comprising bismuth subnitrate suspension (B) 15 mg/ml, oxytetracycline (OT), and metronidazole (M).


METHODS
Treatment I (101 patients): B 5 ml, OT 500 mg, and M 200 mg, all q.i.d. for 14 days. Treatment II (60 patients): B 10 ml and OT 750 mg q.i.d., M 400 mg t.i.d. for 7 days. Treatment III (145 patients): B 10 ml and OT 500 mg q.i.d., M 400 mg t.i.d. for 10 days. Gastroscopy and 14C-urea breath test were performed 4 weeks and 1 year after cessation of therapy.


RESULTS
According to the urea breath test, H pylori eradication rates at 4 weeks were 87.9%, 81.9%, and 95.0% for Treatment I, II and III, respectively. At one year, 4 out of 242 patients, who were H pylori negative at 4 weeks, had become H pylori positive, i.e., H pylori reinfection rate 1.7%, 95% CI 0.5-4.2%. Only one of these "reinfected" patients had ulcer recurrence. Another patient had duodenal ulcer recurrence shortly after cessation of treatment in spite of being H pylori eradicated, i.e., ulcer recurrence rate 0.8%, 95% CI 0.1-3.0%.


CONCLUSIONS
During the first year after H pylori eradication by triple therapy, recurrence rates of H pylori infection and peptic ulcer are very low (below 4.2% and 3.0%, respectively).
Berstad
A
A
Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Hatlebakk
J G
JG
Wilhelmsen
I
I
Berstad
K
K
Bang
C J
CJ
Nysaeter
G
G
Hausken
T
T
Weberg
R
R
Nesje
L B
LB
Hjartholm
A S
AS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000863:Antacids / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001729:Bismuth / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D010118:Oxytetracycline / Q000627:therapeutic use*; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies
D000863:Antacids; D000900:Anti-Bacterial Agents; D008795:Metronidazole; C010804:bismuth subnitrate; D001729:Bismuth; D010118:Oxytetracycline