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Successful low‐dose amoxycillin, metronidazole and omeprazole combination therapy in a population with a high frequency of metronidazole‐resistant Helicobacter pylori
Author(s) -
Breuer T.,
Kim J. G.,
Gurer I. E.,
Graham D. P.,
Osato M.,
Genta R. M.,
Graham D. Y.
Publication year - 1997
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1997.00173.x
Subject(s) - medicine , metronidazole , omeprazole , helicobacter pylori , gastroenterology , amoxicillin , population , antibiotics , microbiology and biotechnology , environmental health , biology
Aim: Effective anti‐ Helicobacter pylori therapies with few side‐effects are needed. We studied the effectiveness of a low‐dose combination of metronidazole, amoxycillin and omeprazole for treatment of ulcer patients in Seoul, Korea. Methods: Patients with gastric or duodenal ulcer received metronidazole (125 mg b.d.), amoxycillin (500 mg b.d.) and omeprazole (20 mg at bedtime) for 2 weeks. Endoscopic examinations were performed before treatment and at least 6 weeks after completion of antimicrobial therapy. H. pylori status was confirmed by histological examination of two gastric biopsies using the Genta stain. Results: Seventy‐nine patients (64 men, 15 women, mean age 46 years) with peptic ulcer were enrolled. H. pylori infection was cured in 56 (71%, 95% CI: 60–81%). The cure rate in non‐smokers was significantly higher than in smokers (88% vs. 65%, P =0.035). Twelve pre‐treatment isolates were available and metronidazole resistance was noted in all; H. pylori infection was cured in 10. Thirty‐six patients cured of H. pylori have been followed for 1 year (mean of 361 days) and 2 cases became reinfected (5.5%, 95% CI: 1–18%). Conclusions: The low‐dose combination of metronidazole, amoxycillin and omeprazole was effective even in the face of metronidazole resistance. Recurrence of H. pylori infection is infrequent even in countries with a high prevalence of H. pylori infection.