Omeprazole plus amoxicillin versus triple therapy eradicates Helicobacter pylori in the Chinese with peptic ulcer disease.

BACKGROUND

Omeprazole/amoxicillin regimen has proved elsewhere to be effective in the eradication of Helicobacter pylori (H. pylori). However, in the Chinese, its role in H. pylori is still unclear.

METHODS

Between November 1993 and June 1994, 112 patients with active, H. pylori positive peptic ulcer were enrolled in this study. Five groups were arranged randomly to have 20 mg omeprazole q.d. for 28 days plus 750 mg amoxicillin b.i.d. for the first 10 days (omep-20-amox group, N = 22), 20 mg omeprazole b.i.d. for 28 days plus 750 mg amoxicillin b.i.d. for the first 10 days (omep-40-amox group, N = 22), 300 mg bismuth subsalicylate q.i.d. for 28 day, and 750 mg amoxicillin b.i.d., 500mg metronidazole t.i.d. for the first 7 days (triple therapy group, N = 25), 20 mg omeprazole q.d. for 28 days (omep-20 group, N = 22), or 150 mg ranitidine b.i.d. or 400 mg cimetidine b.i.d. for 28 days (H2-antagonist group, N = 21).

RESULTS

The eradication rate of H. pylori eight weeks after the entry of study was 38.1% in the omep-20-amox group, 66.7% in the omep-40-amox group, 77.3% in the triple therapy group, 4.7% in the omep-20 group and 0% in the H2 antagonist group (p < 0.05 between the triple therapy and the omep-20-amox, the omep-20, and the H2 antagonist groups). Eleven patients in the triple therapy group suffered from adverse effects (45.8%) (p < 0.05 as compared with other groups). The ulcer healing rates four weeks after the entry of study for the omep-20-amox, the omep-40-amox, the triple therapy, and the omep-20 groups were 80.9%, 80.9%, 68.2%, and 85.7% respectively (p > 0.05). For the H2 antagonist group, the ulcer healing rate eight weeks after the entry of study was 70%.

CONCLUSIONS

Both medium-dose omeprazole/amoxicillin and triple therapy can achieve good eradication rates. However, medium-dose omeprazole/amoxicillin had a much lower side effect. Therefore, we recommend medium-dose omeprazole/amoxicillin for the eradication of H. pylori.