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Randomized comparison of 1‐hour topical method vs. amoxycillin plus omeprazole for eradication of Helicobacter pylori in duodenal ulcer patients
Author(s) -
Krzysztof Przytulski,
Jarosław Reguła,
Anna Dziurkowska-Marek,
Maciej Kohut,
Ewa E. Hennig,
Tomasz Marek,
Jerzy Ostrowski,
Andrzej Nowak,
E Butruk
Publication year - 1998
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.1365-2036.1998.00273.x
Subject(s) - medicine , omeprazole , helicobacter pylori , gastroenterology , ranitidine , rapid urease test , amoxicillin , metronidazole , breath test , group b , antibacterial agent , clarithromycin , discontinuation , randomized controlled trial , antibiotics , gastritis , microbiology and biotechnology , biology
Background: A novel 1‐h topical method eradicated Helicobacter pylori in 96% of dyspeptic patients. The eradication rate of amoxycillin/omeprazole therapy varies from 0 to 93%. Aim: To compare both methods in patients with endoscopically proven duodenal ulcer. Methods: Eighty patients (59 males, 21 females; median age 43 years) were randomized into two therapeutic groups. The first group (group A) was treated with a 6‐week course of ranitidine 300 mg/day, then omeprazole 20 mg b.d. with pronase 36 000 units/day for 2 days, followed by 1‐h topical therapy with a solution of bismuth, metronidazole, amoxycillin and pronase. The second group (group B) consisted of patients treated with omeprazole 20 mg b.d. and amoxycillin 2 g/day for 2 weeks, followed by a 4‐week course of ranitidine 300 mg/day. Eradication of H.␣pylori was assessed by urease test, histology, a polymerase chain reaction and a 13 C‐urea breath test, all of which were performed 4 weeks after discontinuation of the antibacterial treatment. Results: Eradication rates in groups A and B were 2.5% and 35% in an intention‐to‐treat analysis, respectively. Side‐effects were encountered in 40.5% and 12.5% of subjects in groups A and B, respectively. Treatment tolerance was rated as poor by 54% of patients in group A and 2.5% of patients in group B. Conclusions: Both treatment regimens, the 1‐h topical method and amoxycillin with omeprazole, have low eradication rates in patients with duodenal ulcer. In addition, the topical treatment is characterized by a high rate of side‐effects and poor tolerance. Based on the results of our study, neither method can be recommended for eradication of H. pylori in patients with duodenal ulcer.