Pantoprazole suppresses Helicobacter pylori without affecting cure.
BACKGROUND
Short-term, low-dose triple regimens composed of proton-pump inhibitors (PPI) and two antibiotics are the current gold standard therapy for cure of Helicobacter pylori infection. To date, the effect of PPI pretreatment on eradication outcome is not known. The aim of this study was to evaluate the influence of pretreatment with pantoprazole on the efficacy of an ensuing triple therapy.


METHODS
In this open, randomized, monocenter, parallel group comparison, 107 patients with duodenal ulcer or functional dyspepsia were assigned to receive one of the following treatment regimens: a 7-day triple therapy with pantoprazole, 40 mg bid; clarithromycin, 250 mg bid; and metronidazole, 400 mg bid, which was either preceded or followed by a 7-day therapy with pantoprazole, 40 mg (P-PCM or PCM-P). Assessment of H. pylori status was performed by a biopsy urease test and 13C urea breath test at the initial visit and 13C urea breath test at all follow-up visits.


RESULTS
The 7-day pantoprazole pretreatment resulted in a significant decline of the delta values of the 13C urea breath test. H. pylori infection was cured in 47 of 52 intention-to-treat patients of the P-PCM group (90%; 95% confidence interval, 79-97%) and in 46 of 53 of the PCM-P group (87%; 95% confidence interval, 75-95%).


CONCLUSIONS
Pretreatment with pantoprazole suppresses H. pylori but does not impair the efficacy of a consecutive short-term, low-dose triple therapy.
Adamek
R J
RJ
Department of Medicine, St. Josef-Hospital, Ruhr-University, Bochum, Germany.
Szymanski
C
C
Pfaffenbach
B
B
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000494:pharmacology / Q000627:therapeutic use*; D001944:Breath Tests; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000473:pathology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D009853:Omeprazole / Q000031:analogs & derivatives; D000077402:Pantoprazole; D013454:Sulfoxides / Q000494:pharmacology / Q000627:therapeutic use*; D014508:Urea / Q000032:analysis; D014510:Urease / Q000378:metabolism
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D013454:Sulfoxides; D014508:Urea; D000077402:Pantoprazole; D014510:Urease; D009853:Omeprazole