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[Omeprazole modified antibiotic therapy of Helicobacter pylori infection: can clarithromycin be replaced by
J Labenz1, M Wegener, R J Adamek
1Elisabeth-Krankenhaus, Medizinische Klinik, Essen.
Abstract:
Thirty-five consecutive patients (median age: 50 years, 17 men and 18 women) suffering from Helicobacter pylori associated peptic ulcer disease (duodenal ulcer: n = 15, gastric ulcer: n = 13) or severe functional dyspepsia (n = 7) were enrolled in a two-center clinical trial and treated with omeprazole 20 mg bid preprandially and roxithromycin 300 mg bid postprandially over two weeks. After cessation of the study medication, ulcer patients received a full dose H2-blocker treatment up to the final examination four weeks later. All patients completed the trial without contravening the protocol. Side effects were not recorded. The overall proportion of cure of Helicobacter pylori-infection was 29% (10 out of 35 patients) without statistically significant difference between the two participating centers (center I: 7 out of 20 patients [35%], center II: 3 out of 15 patients [20%]; p = 0.33). We conclude from our results that omeprazole plus roxithromycin is an ineffective treatment schedule with regard to cure of H.pylori-infection in patients with peptic ulcer disease or dyspepsia.
Insights
Omeprazole and roxithromycin treatment showed a low 29% cure rate for Helicobacter pylori infection in patients with peptic ulcers or functional dyspepsia. This combination therapy proved ineffective for eradicating H. pylori.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- Helicobacter pylori infection is a primary cause of peptic ulcer disease and functional dyspepsia.
- Effective eradication of H. pylori is crucial for healing and preventing recurrence of gastrointestinal conditions.
Purpose of the Study:
- To evaluate the efficacy of omeprazole plus roxithromycin in curing Helicobacter pylori infection.
- To assess the treatment's effectiveness in patients with peptic ulcer disease and functional dyspepsia.
Main Methods:
- A two-center clinical trial involving 35 patients with H. pylori-associated peptic ulcer disease or severe functional dyspepsia.
- Patients received omeprazole 20 mg bid preprandially and roxithromycin 300 mg bid postprandially for two weeks.
- Ulcer patients continued H2-blocker treatment for four weeks post-study medication.
Main Results:
- The overall H. pylori cure rate was 29% (10 out of 35 patients).
- No statistically significant difference in cure rates was observed between the two participating centers (35% vs. 20%, p = 0.33).
- All patients completed the trial, and no side effects were recorded.
Conclusions:
- Omeprazole plus roxithromycin is an ineffective treatment regimen for curing H. pylori infection.
- This combination therapy is not recommended for patients suffering from peptic ulcer disease or dyspepsia due to low eradication rates.