Optimal dose of omeprazole in combination with amoxicillin in eradicating H. pylori and preventing relapses in duodenal ulcer patients.
OBJECTIVE
Triple therapy schemes, based on bismuth salts, eradicate H.pylori in a high percentage of duodenal ulcer (DU) patients. However, a simple and effective regime with a low complication rate is desirable. Previous studies have shown that the combination of Omeprazole (O) with an antibiotic (most commonly Amoxycillin [A]) is effective, but the optimal dose of O in this combination is not well defined. The aim of this study therefore was to address this subject.


METHODS
The following four groups of patients were studied: group I (20mg O daily + 500mg A qid, n=18), group II (20mg O bid + 500mg A qid, n=17), group III (20mg O tid + 500mg A qid, n=18), group IV (20mg O qid + 500mg A qid, n=20). Patients were treated for two weeks with the above combinations. Endoscopy was performed four weeks after stopping treatment to check for H. pylori eradication and then one year later or when symptoms suggesting relapse occurred.


RESULTS
Eradication rates were as follows; group I 6/18 (33.3%), group II 10/17 (58.8%), group III 15/18 (83.3%), group IV 17/20 (85%). The highest eradication rate was achieved in group IV which was significantly higher (P<0.001) than in all the other groups except for group III. After treatment, there was a total of 48 H. pylori (-) and 25 H. pylori (+) patients in the four groups of patients studied. Relapse occurred in 20/25 (80%) of the H. pylori (+) patients and in only 2/48 (4.16%) of the H. pylori (-) patients (P<0.001).


CONCLUSIONS
a) The combination of Omeprazole and Amoxycillin is effective in eradicating H. pylori. It seems that in this combination 60 or 80mg of Omeprazole is equally effective in achieving high percentages of eradication. Eradication of H. pylori with this regime prevents duodenal ulcer recurrence.
Rokkas
T
T
Gastroenterology Unit, 401 Army General Hospital, Athens, Greece.
Mavrogeorgis
A
A
Liatsos
C
C
Rallis
E
E
Kalogeropoulos
N
N
D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000517:prevention & control; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000008:administration & dosage*; D010406:Penicillins / Q000008:administration & dosage*; D011446:Prospective Studies; D012008:Recurrence
D000897:Anti-Ulcer Agents; D010406:Penicillins; D000658:Amoxicillin; D009853:Omeprazole