One-Week Triple Therapy with Lansoprazole, Clarithromycin, and Metronidazole to Cure Helicobacter pylori Infection in Peptic Ulcer Disease in Korea

The efficacy and acceptability of classicalbismuth triple therapy may be limited by poor patientcompliance and adverse effects. It is widely agreed thatimproved, simpler, and reliable therapies are needed to cure Helicobacter pylori infection andfoster patient compliance. We evaluated the efficacy andside effects of a Bazzoli triple therapy substitutinglansoprazole for omeprazole for H. pylori infection in active peptic ulcer in Korea (30 mg oflansoprazole, 250 mg of clarithromycin, and 400 mg ofmetronidazole, all twice daily). H. pylori status wasevaluated by rapid urease test, histology, and culture at entry and four or more weeks after endingantimicrobial therapy. Fifty-eight patients (mean age:43 years) with gastric (N = 30) or duodenal ulcer (N =28) and H. pylori infection were studied. H. pylori was cured in 47 (81%, 95% CI 69-90%). Mild sideeffects, including vomiting, diarrhea, and itching, wereobserved in four patients (7%). Compliance averaged 95%.Fifty-five ulcers (95%) were healed. Pretreatment pylorobulbar deformity was observed in 49patients (85%), and in 43 (88%) the deformitydisappeared after treatment. Pretreatment metronidazoleand clarithromycin resistance was observed in 87% and 2% of patients, respectively. The cure rate of H.pylori infection was significantly higher in patients>50 years of age than those <50. Treatment withlow-dose one-week lansoprazole, clarithromycin, and metronidazole resulted in a relatively lowcure rate, but was well tolerated. Studies to define theoptimal duration, dose, and dosing interval of thiscombination therapy in Korea are needed.