Omeprazole,clarithromycin and amoxicillin therapy for Helicobacter pylori infection

Objective To determine the eradication rate of Helicobacter pylori (HP) infection using omeprazole 20 mg twice daily, clarithromycin 500 mg twice daily and amoxicillin 1000 mg twice daily for one or two weeks, in comparison with colloidal bismuth subcitrate 240 mg twice daily, amoxicillin 1000 mg twice daily and metronidazole 400 mg twice daily for two weeks. Methods 141 patients with Hp associated chronic gastritis or duodenal ulcer were randomly divided into 3 groups. Group Ⅰ(n＝48) was treated with triple therapy (omeprazole, clarithromycin and amoxicillin) for 1 week, Group Ⅱ (n＝47) treated with triple therapy for two weeks, Group Ⅲ (n＝46) treated with colloidal bismuth subcitrate, amoxicillin and metronidazole for 2 weeks. The Hp status was determined by rapid urease test and histology of Warthin-Starry silver stain. Results The eradication rates of Group Ⅰ, Group Ⅱ and Group Ⅲ were 89.6％, 95.7％ and 71.7％ respectively. The difference between Group Ⅰ and Group Ⅲ or between Group Ⅱ and Group Ⅲ was significant. There was no significant difference in the eradication rates between Group Ⅰ and Group Ⅱ. Side effects in Group Ⅲ was more frequent than in Group Ⅰ and Ⅱ. Although 21.1％ of the patients in Group Ⅰ and Ⅱ experienced a metallic taste, none discontinued in medication. Conclusion Our results show that triple therapy with omeprazole, clarithromycin and amoxicillin is an effective and well tolerated treatment for eradication of Hp infection and may be an alternative to the old standard triple therapy.