[Helicobacter pylori infection: The efficacy of bismuth-tetracyclin-metronidazole triple therapy in patients with duodenal ulcer.].
The aim of the study was to assess the efficacy of two bismuth-tetracyclin-metronidazole "triple therapy" regimes for Helicobacter pylori and their effect of eradication of the bacteria on duodenal ulcer disease. Eighty-two patients (52 males and 30 females, mean age 49 years) with a history of recurrent duodenal ulcer and H. pylori postitive gastritis were included in the study. Treatment I, 35 patients, received colloid bismuth subcitrate (De-Nol(R)) 120 mg q.i.d, tetracyclin 500 mg q.i.d. and metronidazole 400 mg t.i.d. for 14 days. Most patients received omeprazole or H2 blocker during the treatment. Treatment II, 47 patients, received omeprazole 20 mg o.d. on days 1-14 and colloid bismuth subcitrate 120 mg q.i.d., tetracyclin 250 mg q.i.d. and metronidazole 250 mg q.i.d. on days 4-14. Eradication was regarded successful if gastric biopsy was H. pylori negative by urease test three months or more after treatment. All patients were able to complete the treatment. Eradication of H. pylori was successful in 34 (97%) in group I and in 43 (92%) in group II. The mean endoscopic follow-up period was 9.4 months in group I and 16.0 in group II. Follow-up with regard to subjective symptoms was on average 20 months long. Five patients in group I and eight in group II had a mild symptom recurrence without reinfection. Two (2.5%) patients (one in each group) had a recurrent ulcer. Adverse effects were common in both groups and four patients, all in group I, had severe symptoms. It was estimated that the successful H. pylori eradication and excellent symptom response in most of the patients had saved seven million Icelandic krónur in drug expenses in the whole group.
Gudjonsson
H
H
Astradsdottir
H
H
Thjodleifsson
B
B