Omeprazole-amoxycillin therapy for eradication ofHelicobacter pylori in duodenal ulcer bleeding: Preliminary results of a pilot study

Abstract

Thirty-five patients with duodenal ulcer bleeding andHelicobacter pylori-colonization were assigned to receive 2×20 mg omeprazole and 3×750 mg amoxycillin daily for 2 weeks. Eradication was defined as no evidence ofH. pylori infection by urease test and by histology 4 weeks after completion of therapy. Two patients were lost to follow up. All ulcers healed completely (100% ulcer healing rate). Twenty-nine out of the 33 patients wereH. pylori-negative (87.9% eradication rate). Three patients complained of typical side effects of amoxycillin (9.1% side effect rate). The patients were prospectively followed for 12 months. After ulcer healing, no maintenance therapy was given. One of the 29 patients in whomH. pylori eradication had been successful suffered a second ulcer hemorrhage withH. pylori re-infection (3.4% relapse rate of ulcer bleeding), and this was managed endoscopically. Recurrent ulcer hemorrhage occurred in 2 out of 4H. pylori-resistant patients. At the end of the follow-up period, of the patients in whomH. pylori eradication had been initially successful, only the patient with re-bleeding remained re-infected. The 4H. pylori-resistant patients showed persistentH. pylori colonization. In conclusion, omeprazole plus amoxycillin is a safe and effective treatment for eradicatingH. pylori; this treatment reduces the relapse rate of duodenal ulcer bleeding.