No additional value of bismuth subcitrate to combination omeprazole/amoxicillin therapy in the eradication of Helicobacter pylori.
BACKGROUND
We investigated whether addition of bismuth subcitrate (BSC, 4 x 120 mg) to a two week therapy scheme of omeprazole (OME, 2 x 40 mg)/amoxicillin (AMO, 4 x 500 mg) increases Helicobacter pylori eradication.


METHODS
Patients with dyspepsia underwent upper endoscopy. H. pylori positive patients were randomized to treatment A (OME/AMO, 83 patients) or treatment B (OME/AMO/BSC, 84 patients).


RESULTS
In 65 patients of group A (78%) H. pylori was eradicated as determined from the histological assessment (Sydney classification) of antrum and corpus biopsies. In comparison, in 68 patients of group B (81%) H. pylori was eradicated (p = NS between groups). H. pylori eradication in both groups was associated similarly with a decrease of inflammation and activity whereas atrophy and intestinal metaplasia were not affected. A positive association was revealed between the decrease of H. pylori score and the decrease of both inflammation and activity scores for antrum as well as corpus biopsies.


CONCLUSIONS
Addition of BSC to OME/AMO does not increase H. pylori eradication in patients with dyspepsia. Eradication of H. pylori is associated with disappearance of epithelial damage (inflammation and activity) in antral and corpus mucosa.
Tan
A C
AC
Department of Hepato-Gastroenterology, Rijnstate Hospital, Arnhem, The Netherlands. AdriaanTan@compuserve.com
den Hartog
G
G
Meijer
J W
JW
Thies
J E
JE
de Vries
R A
RA
Mulder
C J
CJ
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001284:Atrophy / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D001706:Biopsy; D003627:Data Interpretation, Statistical; D003967:Diarrhea / Q000139:chemically induced; D004064:Digestive System / Q000473:pathology; D004359:Drug Therapy, Combination; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D010406:Penicillins / Q000627:therapeutic use*; D011706:Pyloric Antrum / Q000382:microbiology / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D009942:Organometallic Compounds; D010406:Penicillins; D000658:Amoxicillin; C002791:bismuth tripotassium dicitrate; D009853:Omeprazole