Impact of intravenous omeprazole on Helicobacter pylori eradication by triple therapy in patients with peptic ulcer bleeding.
OBJECTIVE
To test the impact of intravenous omeprazole on Helicobacter pylori eradication for bleeding peptic ulcers.


METHODS
A total of 175 H. pylori-infected patients with bleeding peptic ulcers were randomized into either an omeprazole group or a ranitidine group, receiving intravenous omeprazole or ranitidine for 3 days after endoscopy. Afterwards, 1-week triple therapy was used to eradicate H. pylori for both groups. Six weeks later, either a 13C-urea breath test or follow-up endoscopy was performed to assess the success of H. pylori eradication.


RESULTS
The rebleeding rate was lower in the omeprazole group vs. the ranitidine group (6% vs. 17%, P < 0.05). The H. pylori eradication rate was higher in the omeprazole group (intention-to-treat analysis: 83% vs. 66%, P < 0.05; per protocol analysis: 93% vs. 80%, P < 0.05). For patients with duodenal ulcers, the per protocol H. pylori eradication rate of the omeprazole group was higher than that of the ranitidine group (93% vs. 73%, P < 0.05).


CONCLUSIONS
Intravenous omeprazole can decrease the risk of rebleeding of peptic ulcers. For duodenal ulcers, in particular, intravenous omeprazole may even improve the H. pylori eradication rate of the subsequent triple therapy.
Sheu
B-S
BS
Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan. sheubs@mail.ncku.edu.tw
Chi
C-H
CH
Huang
C-C
CC
Kao
A-W
AW
Wang
Y-L
YL
Yang
H-B
HB
D000284:Administration, Oral; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000897:Anti-Ulcer Agents; D001944:Breath Tests; D017291:Clarithromycin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004724:Endoscopy; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects / Q000472:pathogenicity; D006470:Hemorrhage; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000008:administration & dosage; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology; D011899:Ranitidine; D012008:Recurrence; D016896:Treatment Outcome; D014508:Urea / Q000032:analysis
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D010406:Penicillins; D000658:Amoxicillin; D011899:Ranitidine; D014508:Urea; D017291:Clarithromycin