Different effects of short-term omeprazole, lansoprazole or pantoprazole on the accuracy of the (13)C-urea breath test.
BACKGROUND
Proton pump inhibitors may interfere with the accuracy of the (13)C-urea breath test, but little information is available on the effect of standard doses of various proton pump inhibitors on this test.


OBJECTIVE
To evaluate the effect of short-term standard doses of omeprazole, lansoprazole and pantoprazole on the accuracy of the standardized (13)C-urea breath test.


METHODS
A total of 124 patients with Helicobacter pylori infection, diagnosed on the basis of gastric histology, rapid urease test and (13)C-urea breath test, were studied. These patients received omeprazole, 20 mg/day, lansoprazole, 30 mg/day, or pantoprazole, 40 mg/day, for 2 weeks according to a randomized protocol. (13)C-Urea breath test was repeated on days 4, 7 and 14 while on therapy and 7 days after proton pump inhibitor withdrawal.


RESULTS
Of the patients receiving omeprazole and lansoprazole, 30% (12/40) and 20% (8/41), respectively, became (13)C-urea breath test negative during therapy, compared with none of the 42 patients treated with pantoprazole (P < 0.05). All the false negative (13)C-urea breath test results returned to positive within 1 week of drug withdrawal, with a mean recovery to 84.7 +/- 15.6% of baseline delta(13)CO(2).


CONCLUSIONS
Short-term omeprazole and lansoprazole interfere with the 13C-urea breath test, although a return to positive test results invariably occurs within 1 week of proton pump inhibitor withdrawal. In contrast, the accuracy of the (13)C-urea breath test does not appear to be significantly impaired by short-term pantoprazole, which therefore may not necessarily be withdrawn before this test.
Parente
F
F
Department of Gastroenterology, L. Sacco University Hospital, Milan, Italy.
Sainaghi
M
M
Sangaletti
O
O
Imbesi
V
V
Maconi
G
G
Anderloni
A
A
Bianchi Porro
G
G
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000494:pharmacology; D001562:Benzimidazoles / Q000008:administration & dosage* / Q000494:pharmacology*; D001944:Breath Tests / Q000379:methods*; D002247:Carbon Isotopes; D004347:Drug Interactions; D005188:False Negative Reactions; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000494:pharmacology*; D000077402:Pantoprazole; D012680:Sensitivity and Specificity; D013454:Sulfoxides / Q000008:administration & dosage* / Q000494:pharmacology*; D013997:Time Factors; D014508:Urea
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D002247:Carbon Isotopes; D013454:Sulfoxides; D064747:Lansoprazole; D014508:Urea; D000077402:Pantoprazole; D009853:Omeprazole