Effectiveness of Quadruple Therapy Using Lansoprazole, Instead of Omeprazole, in Curing Helicobacter pylori Infection

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Abstract
Background.Omeprazole enhances the efficacy of bismuth‐based triple therapy. It is unknown whether the same is true for other proton pump inhibitors. Lansoprazole has superior anti‐Helicobacter activity in vitro and possibly also in vivo; therefore we investigated quadruple therapy with lansoprazole. Materials and Methods.In two studies performed in separate hospitals, a total of 67 Helicobacter pylori–positive patients were treated with 7‐day quadruple therapy (lansoprazole, colloidal bismuth subcitrate, tetracycline, and metronidazole) after 3 days of lansoprazole pretreatment. Testing for cure was done by endoscopy in study 1 and by breath test in study 2. Results.Cure rates per protocol were 31 of 31 (100%) in study 1 and 30 of 32 (94%) in study 2. Intention‐to‐treat cure rates were 31 of 35 (89%) in study 1 and 30 of 32 (94%) in study 2. Cured overall were 32 of 34 with a metronidazole sensitive strain and 3 of 3 with a metronidazole‐resistant strain. Data on side effects were collected from 51 patients. Twelve (21%) had no side effects, 27 (53%) had mild side effects, 10 (20%) had moderate side effects, but only 2 (4%) had severe side effects. Side effects, never were the reason that a patient stopped taking the medication. Conclusions.The results with lansoprazole‐quadruple therapy are comparable to the historic control group treated with omeprazole‐quadruple therapy. The cure rate is very high, and although mild to moderate side effects occured in many patients, everybody finished the treatment regime.

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