Digestive Diseases and Sciences

, Volume 39, Issue 7, pp 1483–1487 | Cite as

Medium- and high-dose omeprazole plus amoxicillin for eradication ofHelicobacter pylori in duodenal ulcer disease

  • Joachim Labenz
  • Georg H. Rühl
  • Jörg Bertrams
  • Gereon Börsch
Original Articles


The purpose of the present study was to investigate theHelicobacter pylori eradication potency of combined amoxicillin-omeprazole treatment in patients with duodenal ulcer disease and to compare the efficacy of two omeprazole and amoxicillin doses concerningH. pylori eradication, ulcer healing, pain relief, and safety. Ninety patients with activeH. pylori-positive (culture and/or histology) duodenal ulcer disease were randomly treated with either omeprazole 20 mg twice a day plus amoxicillin 1 g twice a day (group I,N=30), omeprazole 40 mg twice a day plus amoxicillin 1 g twice a day (group II,N=30), or omeprazole 40 mg twice a day plus amoxicillin 1 g three times a day (group III,N=30) over two weeks, followed by ranitidine at bedtime for another four weeks. The overall proportion ofH. pylori eradication was 83% and of ulcer healing 92% without statistically significant differences between the study groups. Complete pain relief occurred after a median of one day in all groups. Six patients complained of side effects during the therapy phase, which led to therapy discontinuation in one female patient. In conclusion, omeprazole plus amoxicillin is a highly effective and well-tolerated therapy regimen to eradicateH. pylori in duodenal ulcer disease. In addition, the results suggest that there is no clear dose-response relation between the dosages of omeprazole and amoxicillin used in this study on the one hand and theH. pylori eradication rates on the other.

Key words

amoxicillin duodenal ulcer Helicobacter pylori omeprazole 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Graham DY, Lew GM, Klein PD, Evans DG, Evans DJ, Saeed ZA, Malaty HM: Effect of treatment ofHelicobacter pylori infection on the long-term recurrence of gastric or duodenal ulcer. Ann Intern Med 116:705–708, 1992Google Scholar
  2. 2.
    Hentschel E, Brandstätter G, Dragosics M, Hirschl AM, Nemec H, Schütze K, Taufer M, Wurzer H: Effect of ranitidine and amoxicillin plus metronidazole on the eradication ofHelicobacter pylori and the recurrence of duodenal ulcer. N Engl J Med 328:308–312, 1993Google Scholar
  3. 3.
    Rauws EAJ, Langenberg W, Houthoff HJ, Zanen HC, Tytgat GNJ:Campylobacter pyloridis-associated chronic active gastritis. A prospective study of its prevalence and the effect of antibacterial and antiulcer treatment. Gastroenterology 94:33–40, 1988Google Scholar
  4. 4.
    Rauws EAJ, Tytgat GNJ: Cure of duodenal ulcer associated with eradication ofHelicobacter pylori. Lancet 2:1233–1235, 1990Google Scholar
  5. 5.
    Graham DY: Treatment of peptic ulcers caused byHelicobacter pylori. N Engl J Med 328:349–350, 1993Google Scholar
  6. 6.
    Tytgat GNJ, Axon ATR, Dixon MF, Graham DY, Lee A, Marshall BJ:Helicobacter pylori: Causal agent in peptic ulcer disease? Working Party Report. World Congresses of Gastroenterology: August 26–31 1990, Sydney, Australia. Oxford, Blackwell Scientific Publications, 1990, pp 36–45Google Scholar
  7. 7.
    Adamek RJ, Wegener M, Birkholz S, Opferkuch W, Rühl GH, Wedmann B: Modified combined omeprazole/amoxicillin therapy regimen for eradication ofH. pylori—a pilot study. Ir J Med Sci 161(suppl 10):90, 1992Google Scholar
  8. 8.
    Bayerdörffer E, Mannes GA, Sommer A, Höchteyr W, Weingart J, Hatz R, Lehn N, Ruckdeschel G, Dirschedl P, Stolte M: High dose omeprazole treatment combined with amoxicillin eradicatesHelicobacter pylori. Eur J Gastroenterol Hepatol 4:697–702, 1992Google Scholar
  9. 9.
    Labenz J, Gyenes E, Rühl GH, Börsch G: Omeprazole plus amoxicillin: Efficacy of various treatment regimens to eradicateHelicobacter pylori. Am J Gastroenterol 88:491–495, 1993Google Scholar
  10. 10.
    Börsch G, Labenz J, Rehner M, Rühl GH, Gyenes E: Nachweis vonHelicobacter pylori. Münch Med Wochenschr 132:391–394, 1990Google Scholar
  11. 11.
    Labenz J, Gyenes E, Rühl GH, Peitz U, Börsch G: Diagnosis ofHelicobacter pylori colonization of the gastric mucosa. A prospective comparative study of direct tests and validity of a new urease test. Med Klin 86:461–464, 1991Google Scholar
  12. 12.
    Börsch GMA, Graham DY:Helicobacter pylori.In Handbook of Experimental Pharmacology, Vol 99, Pharmacology of Peptic Ulcer Disease. SB Benjamin, MJ Collen (eds). Berlin, Springer, 1991, pp 107–147Google Scholar
  13. 13.
    Chiba N, Rao BV, Rademaker JW, Hunt RH: Meta-analysis of the efficacy of antibiotic therapy in eradicatingHelicobacter pylori. Am J Gastroenterol 87:1716–1727, 1992Google Scholar
  14. 14.
    Labenz J, Gyenes E, Rühl GH, Börsch G: Amoxicillin plus omeprazole versus triple therapy for eradication ofHelicobacter pylori in duodenal ulcer disease. Gastroenterology 104:A126, 1993Google Scholar
  15. 15.
    Stolte M, Bethge B: Elimination ofHelicobacter pylori under treatment with omeprazole. Z Gastroenterol 28:271–274, 1990Google Scholar
  16. 16.
    McNulty CAM: Bacteriological and pharmacological basis for the treatment ofCampylobacter pylori infection. InCampylobacter pylori. BJ Rathbone, RV Heatley (eds). Oxford, Blackwell Scientific Publications, 1989, pp 209–216Google Scholar
  17. 17.
    Hunt RH: pH and Hp—gastric acid secretion andHelicobacter pylori: Implications for ulcer healing and eradication of the organism. Am J Gastroenterol 88:481–483, 1993Google Scholar
  18. 18.
    Atherton JC, Washington N, Bracewell MA, Sutton LJ, Greaves JL, Perkins AC, Hawkey CJ, Spiller RC: Effect of food and omeprazole on gastric distribution and emptying of amoxycillin. Acta Gastroenterol Belg 56 (suppl):65, 1993Google Scholar
  19. 19.
    De Koster E, Nyst JF, Deprez C, Glupczynski Y, Otero J, Denis P, Van Geel J, Buset M, De Reuck M, Deltenyre M: HP treatment: Disappointing results with amoxicillin plus omeprazole. Ital J Gastroenterol 23(suppl 2):105, 1991Google Scholar
  20. 20.
    Lamouliatte H, Megraud F, De Mascarel A, Barberis C, Bernhard PH, Cayla R, Quinton A: Does omeprazole improve amoxycillin therapy directed towardsCampylobacter pylori-associated chronic gastritis? Klin Wochenschr 67(suppl 18):37, 1989Google Scholar
  21. 21.
    Graham DY, Lew GM, Malaty HM, Evans DG, Evans DJ, Klein PD, Alpert LC, Genta RM: Factors influencing the eradication ofHelicobacter pylori with triple therapy. Gastroenterology 102:493–496, 1992Google Scholar
  22. 22.
    Unge P, Gad A, Eriksson K, Bergman B, Carling L, Ekström P, Glise H, Gnarpe H, Junghard O, Lindholmer C, Sandzen B, Strandberg L, Stubberöd A, Weywadt L: Amoxicillin added to omeprazole prevents relapse in the treatment of duodenal ulcer patients. Eur J Gastroenterol Hepatol 5:325–331, 1993Google Scholar
  23. 23.
    Burget DW, Chiverton SG, Hunt RH: Is there an optimal degree of acid suppression for healing of duodenal ulcers? Gastroenterology 99:345–351, 1990Google Scholar

Copyright information

© Plenum Publishing Corporation 1994

Authors and Affiliations

  • Joachim Labenz
    • 1
    • 2
    • 3
  • Georg H. Rühl
    • 1
    • 2
    • 3
  • Jörg Bertrams
    • 1
    • 2
    • 3
  • Gereon Börsch
    • 1
    • 2
    • 3
  1. 1.From the Department of Internal MedicineElisabeth Hospital, Academic Teaching Hospital of the University of EssenEssenGermany
  2. 2.Department of Laboratory MedicineElisabeth Hospital, Academic Teaching Hospital of the University of EssenEssenGermany
  3. 3.Institute of PathologyRuhruniversity BochumGermany

Personalised recommendations