A new highly effective short-term therapy schedule for Helicobacter pylori eradication.
BACKGROUND
Although triple therapy regimens suggested in the Current European guidelines give fairly good results, several studies have reported an unsatisfactory Helicobacter pylori eradication rate (< 80%).


OBJECTIVE
To evaluate the efficacy of a new short-term treatment sequence on H. pylori eradication.


METHODS
A total of 52 patients with H. pylori infection and either non-ulcer dyspepsia (34 patients) or peptic ulcer (18 patients) were enrolled to receive a 10-day therapy: omeprazole 20 mg b.d. plus amoxycillin 1 g b.d. for the first 5 days, followed by omeprazole 20 mg b.d., clarithromycin 500 mg b.d. and tinidazole 500 mg b.d. for the remaining 5 days. H. pylori infection at entry was assessed by rapid urease test and histology on biopsies from the antrum and the corpus. Bacterial eradication was assessed by endoscopy (peptic ulcer patients) or 13C urea breath test (non-ulcer dyspepsia patients) 4-6 weeks after therapy had ended.


RESULTS
All patients completed the study. H. pylori eradication was achieved in all but one patient, with an eradication rate of 98% (95% CI: 94.3-100) with intention-to-treat analysis. Patient compliance was good (consumption of prescribed drugs > 95%) for all but one patient, who took the triple therapy regimen for 4 days instead of 5 days. No major side-effects were reported but three (6%) patients complained of mild side-effects.


CONCLUSIONS
The use of this 'five plus five' therapy schedule as an initial treatment for H. pylori deserves further investigation.
Zullo
A
A
Department of Clinical Medicine, Gastroenteology II, 'La Sapienza' University, Rome, Italy. s.morini@flashnet.it
Rinaldi
V
V
Winn
S
S
Meddi
P
P
Lionetti
R
R
Hassan
C
C
Ripani
C
C
Tomaselli
G
G
Attili
A F
AF
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000994:Antitrichomonal Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use; D010349:Patient Compliance; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use; D013276:Stomach Ulcer / Q000209:etiology / Q000382:microbiology; D014011:Tinidazole / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000994:Antitrichomonal Agents; D010406:Penicillins; D014011:Tinidazole; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole