Four-day lansoprazole-quadruple therapy in the routine treatment of Helicobacter pylori infection.
BACKGROUND
Ulcer patients need to be treated for Helicobacter pylori infection. Seven days of quadruple therapy achieves the highest cure rates. In this study a 4-day quadruple regimen of lansoprazole, bismuth, tetracycline and metronidazole is investigated.


METHODS
In an open study 66 consecutive infected patients with ulcer disease or non-ulcer dyspepsia were treated with 4-day quadruple therapy after 3 days of lansoprazole pretreatment. H. pylori status was determined before and at least 6 weeks after therapy by endoscopy with antral and corpus biopsies for rapid urease test, histology and culture.


RESULTS
Sixty-four patients took the medication and complete compliance was achieved in 60 (94%). Tolerability was excellent and there were no drop-outs due to side-effects. Overall 55 out of 64 (86%, 95% CI 77.4-94.4%) were cured, including 41/44 with a metronidazole-sensitive strain 5/8 with a resistant strain.


CONCLUSIONS
Four-day quadruple therapy is well tolerated and very effective especially in metronidazole-sensitive strains. This study lends further support for the use of one-week quadruple therapy as empiric first line anti-Helicobacter therapy for Dutch ulcer patients. If patients suffer from side-effects during this therapy stopping treatment at day 4 can be advised.
de Boer
W A
WA
Department of Internal Medicine, Sint Anna Ziekenhuis, Oss, Netherlands.
van Etten
R J
RJ
Schneeberger
P M
PM
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009426:Netherlands; D009853:Omeprazole / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009942:Organometallic Compounds / Q000008:administration & dosage*; D013752:Tetracycline / Q000008:administration & dosage*; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D009942:Organometallic Compounds; D064747:Lansoprazole; D008795:Metronidazole; D013752:Tetracycline; C002791:bismuth tripotassium dicitrate; D009853:Omeprazole