One-week triple therapy with omeprazole, amoxycillin and clarithromycin for treatment of Helicobacter pylori infection

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Abstract
Background: Multi‐drug regimens are generally required to reliably cure H. pylori infection. We previously demonstrated that a 2‐week three‐times‐a‐day regimen of amoxycillin and clarithromycin was effective against H. pylori infection. Objectives: To evaluate the efficacy and side‐effects of a 1‐week twice‐daily dosing schedule for the treatment of H. pylori infection. Methods: We studied the efficacy of 1‐week of therapy with 20 mg of omeprazole, 1 g of amoxycillin and 250 mg of clarithromycin, all twice daily H. pylori status was determined at entry and 4 or more weeks after completing antimicrobial therapy using histology (Genta stain) and culture. Results: Thirty‐one patients with documented peptic ulcer disease and H. pylori infection were treated. The H. pylori infection was cured in 24 (77%, 95% CI= 58–90%) (intention‐to‐treat). In a per protocol analysis the cure rate was 23 of 29 patients (79%, 95% CI= 60–92%). One patient took only 43% of the study drugs and another withdrew following development of an anaphylactic reaction to study medication. Mild side‐effects were reported by 16% including diarrhoea, headache and altered taste. Compliance averaged 95%. Pretreatment clarithromycin resistance averaged 5% and had not been acquired by any strains post‐therapy. Conclusion: This combination of omeprazole, amoxycillin and low‐dose clarithromycin resulted in a relatively low cure rate even in patients with clarithromycin‐sensitive isolates. Large comparative studies will be needed to define the optimal duration, dose and dosing interval if this combination of drugs is to become competitive.

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