Is a one-week course of triple anti-Helicobacter pylori therapy sufficient to control active duodenal ulcer?
BACKGROUND
Triple therapy currently forms the cornerstone of the treatment of patients with Helicobacter pylori-positive duodenal ulcer.


OBJECTIVE
To establish whether prolonged antisecretory therapy is necessary in patients with active duodenal ulcer.


METHODS
A total of 77 patients with H. pylori-positive duodenal ulcer were included in a prospective, controlled, double-blind study. All patients received a 7-day treatment with omeprazole 20 mg b.d., clarithromycin 500 mg b.d. and amoxicillin 1000 mg b.d. Patients in the omeprazole group underwent an additional 14-day therapy with omeprazole 20 mg; patients in placebo group received placebo. Endoscopy was performed upon inclusion in the study and after 3 and 8 weeks.


RESULTS
Seventy-four patients were eligible for a per protocol analysis after 3 weeks, and 65 after 8 weeks. After 3 weeks, the healing rate was 89% in the omeprazole group and 81% in the placebo group (P=0.51). After 8 weeks, the ulcer healed in 97% of the patients in the total group (95% CI: 92.7-100%). H. pylori was eradicated in 88% of patients in the omeprazole group and in 91% in the placebo group (P=1.0). No statistically significant differences between the groups were found in ulcer-related symptoms or in ulcer healing.


CONCLUSIONS
In patients with H. pylori-positive duodenal ulcer, a 7-day triple therapy alone is sufficient to control the disease.
Tepes
B
B
Medical Center Rogaska, Rogaska Slatina, Slovenia. bojan.tepes@rogaska.com
Krizman
I
I
Gorensek
M
M
Gubina
M
M
Orel
I
I
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage* / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000494:pharmacology; D017291:Clarithromycin / Q000008:administration & dosage* / Q000494:pharmacology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004381:Duodenal Ulcer / Q000188:drug therapy* / Q000382:microbiology; 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* / Q000494:pharmacology; D010406:Penicillins / Q000008:administration & dosage* / Q000494:pharmacology; D010919:Placebos; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D010406:Penicillins; D010919:Placebos; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole