Abstract
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.
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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, 1992
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, 1993
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, 1988
Rauws EAJ, Tytgat GNJ: Cure of duodenal ulcer associated with eradication ofHelicobacter pylori. Lancet 2:1233–1235, 1990
Graham DY: Treatment of peptic ulcers caused byHelicobacter pylori. N Engl J Med 328:349–350, 1993
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 36–45
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, 1992
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, 1992
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, 1993
Börsch G, Labenz J, Rehner M, Rühl GH, Gyenes E: Nachweis vonHelicobacter pylori. Münch Med Wochenschr 132:391–394, 1990
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, 1991
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 107–147
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, 1992
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, 1993
Stolte M, Bethge B: Elimination ofHelicobacter pylori under treatment with omeprazole. Z Gastroenterol 28:271–274, 1990
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 209–216
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, 1993
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, 1993
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, 1991
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, 1989
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, 1992
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, 1993
Burget DW, Chiverton SG, Hunt RH: Is there an optimal degree of acid suppression for healing of duodenal ulcers? Gastroenterology 99:345–351, 1990
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Labenz, J., Rühl, G.H., Bertrams, J. et al. Medium- and high-dose omeprazole plus amoxicillin for eradication ofHelicobacter pylori in duodenal ulcer disease. Digest Dis Sci 39, 1483–1487 (1994). https://doi.org/10.1007/BF02088052
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DOI: https://doi.org/10.1007/BF02088052