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Is eradication sufficient to heal gastric ulcers in patients infected with Helicobacter pylori ? A randomized, controlled, prospective study
Author(s) -
Higuchi K.,
Fujiwara Y.,
Tominaga K.,
Watanabe T.,
Shiba M.,
Nakamura S.,
Oshitani N.,
Matsumoto T.,
Arakawa T.
Publication year - 2003
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.1365-2036.2003.01402.x
Subject(s) - medicine , proton pump inhibitor , helicobacter pylori , clarithromycin , gastroenterology , amoxicillin , omeprazole , surgery , antibiotics , biology , microbiology and biotechnology
Summary Background : In Helicobacter pylori infection, the effect of short‐term triple therapy with proton pump inhibitor plus two antibiotics on gastric ulcer healing is not well known. Aim : To compare 1‐week triple therapy with 8‐week proton pump inhibitor therapy on gastric ulcer healing in infected patients. Patients and methods : We randomly assigned 120 patients with H. pylori and gastric ulcers to proton pump inhibitor plus amoxicillin and clarithromycin for 1 week ( n = 61) or proton pump inhibitor alone for 8 weeks ( n = 59), with endoscopic assessment of ulcer healing 8 weeks after the start of treatment. Results : Triple therapy eradicated H. pylori in 51 patients [intention‐to‐treat, 84%; 95% confidence interval (CI), 75–93%]. At 8 weeks, gastric ulcers were healed in 30 patients given triple therapy (49%; 95% CI, 37–62%) and in 49 patients given proton pump inhibitor (83%; 95% CI, 73–93%, P < 0.001). Healing rates in the triple therapy and proton pump inhibitor‐only groups were 89% and 100%, respectively, for ulcers of < 1.0 cm in diameter, 54% and 77% for ulcers of 1.0 to < 1.5 cm in diameter, and 5% and 77% ( P < 0.001) for ulcers of ≥ 1.5 cm in diameter. Conclusions : One‐week triple therapy healed most ulcers of < 1.0 cm, but not ulcers of ≥ 1.5 cm. Short‐term therapy is effective for gastric ulcers of < 1.0 cm, but, for larger ulcers, follow‐up therapy to suppress acid is needed.