Esomeprazole versus omeprazole for the eradication of Helicobacter pylori infection: results of a randomized controlled study.
BACKGROUND
Esomeprazole has higher oral bioavailability and increased antimicrobial activity against Helicobacter pylori than omeprazole.


OBJECTIVE
To compare 7 days esomeprazole with 7 days of omeprazole based triple therapies for the eradication of H. pylori, and to assess whether the administration of higher dose of esomeprazole leads to improved eradication rates.


METHODS
One hundred and fifty-six dyspeptic patients with H. pylori received either: (1) 1-week treatment including esomeprazole 40 mg once daily, amoxicillin 1 g, and clarithromycin 500 mg, both twice daily (EAC1 group, n = 52); (2) 1-week treatment of omeprazole 20 mg, amoxicillin 1 g, and clarithromycin 500 mg, all administered twice daily (OAC group, n = 52); or (3) 1-week treatment with esomeprazole 40 mg, amoxicillin 1 g, and clarithromycin 500 mg, all given twice daily (EAC2 group, n = 52).


RESULTS
H. pylori was eradicated in 37 of 52 patients in the OAC group (Intension to treat [ITT] 71%), and in 42 patients in the EAC1 group (ITT 81%). High eradication rate was achieved by the EAC2 regimen (ITT; 96%), but more patients reported unwanted effects.


CONCLUSIONS
Seven days of esomeprazole based triple therapy is a satisfactory eradication regimen for H. pylori infection. Higher doses of esomeprazole have excellent eradication rates, but they may lead to increased side effects.
Anagnostopoulos
George K
GK
Gastroenterology Department, 251 Hellenic Air Force and Veterans General Hospital, Athens, Greece. gkanagnostopoulos@yahoo.gr
Tsiakos
Stavros
S
Margantinis
George
G
Kostopoulos
Panagiotis
P
Arvanitidis
Dimitrios
D
D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D064098:Esomeprazole; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000188:drug therapy* / Q000382:microbiology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000008:administration & dosage*; D010865:Pilot Projects; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D016896:Treatment Outcome
D009853:Omeprazole; D064098:Esomeprazole