Duodenal ulcer healing after 7-day treatment: a pilot study with lansoprazole, amoxicillin and clarithromycin.

OBJECTIVE: To evaluate the efficacy and safety of a one-week triple therapy without bismuth and metronidazole in duodenal ulcer healing and symptom relief.

PATIENTS AND METHODS: Forty-five patients with duodenal ulcers and Helicobacter pylori (H. pylori) infections were given a 7-day treatment with lansoprazole 30 mg bid, amoxicillin 1.000 mg bid, and clarithromycin 500 mg bid. Endoscopies with urease tests and histologic examinations were performed before initiation and four weeks after cessation of therapy.

RESULTS: Using efficacy analysis, 41 of 42 duodenal ulcers (98%; 95% CI 0.87-1.00) were healed after one week of treatment. H. pylori was eradicated in 40 of 42 patients (95%; 95% CI 0.84-1.00). Two patients with healed ulcers showed a persistent infection, whereas H. pylori was eradicated in the one patient with persisting ulcer. Using intention-to-treat analysis, ulcer healing was achieved in 41 of 45 (91%; 95% CI 0.79-0.98) and H. pylori eradication in 40 of 45 patients (89%; 95% CI 0.76-0.96). After a mean of five days, 40 of 41 patients (98%; 95% CI 0.87-1.00) with ulcer healing became completely pain-free.

CONCLUSIONS: One-week therapy with lansoprazole, amoxicillin and clarithromycin is highly effective in duodenal ulcer healing and symptom improvement. Prolonged acid suppression does not seem to be essential for duodenal ulcer treatment.