Ultra-short therapy for the treatment of Helicobacter pylori. (c2001)

Abstract

Background: Treatment regimens for Helicobacter pylori (H. pylori) usually combine an acid reducing agent (proton-pump inhibitor, H2-antagonist) with two or three antibiotics (macrolide, metronidazole, tetracycline, amoxicillin), with a duration varying from seven to fourteen days. Recently, studies have shown acceptable eradication rates using short-term triple-therapy regimens. Azithromycin, a new generation macrolide with improved pharmacokinetic properties (long t1/2 life and large volume of distribution), has been proposed for H. pylori treatment with variable radication rates of 57% to 93%. Objectives: The purpose of this study is to establish the safety and efficacy of two short-term triple-therapy regimens (lansoprazole, azithromycin and amoxicillin) for H. pylori eradication. Methods: From April 2000 to September 2000 thirty symptomatic patients with a positive rapid urease assay for H. pylori were assigned to receive either a 3-day therapy (Group A) or a 5-day therapy (Group B). In both groups, patients received lansoprazole 30mg bid on day 1; lansoprazole 30mg bid, amoxicillin 19 bid and azithromycin on days 2 and 3. Patients in group B received lansoprazole 30mg bid and amoxicillin 19 bid for two additional days (4 and 5). In-vitro antimicrobial susceptibility of H. pylori recovered from gastric biopsies was tested using the epsilometer test (E-test). Compliance and side effects were monitored. Evaluation of H. pylori eradication was done a minimum of four weeks after end of therapy using the 14C-urea breath test.