COMPARISON OF 3 DIFFERENT THERAPEUTIC REGIMENS FOR ERADICATING HELICOBACTER-PYLORI

The theory that Helicobacter pylori infection may be involved in ulcer disease suggests a potential role for antibacterial therapy. To compare three different therapeutic regimens and evaluate their effects on gastric histology and blood parameters, a 4-week study was conducted in which 32 patients with H pylori-related gastroduodenal pathologies (gastritis or gastric or duodenal ulcer) were randomly assigned to one of three treatment groups. Patients in group 1 received amoxicillin for 15 days, then metronidazole for 10 days; those in group 2 received amoxicillin for 15 days, then metronidazole for 10 days, plus colloidal bismuth subcitrate throughout the 25 days of treatment; and those in group 3 received amoxicillin for 15 days, then metronidazole for 10 days, plus omeprazole throughout the 25 days of treatment. To verify whether the pathogen had been eradicated, endoscopy was performed 2 months after treatment was discontinued. No statistically significant differences were seen between the three groups; eradication was achieved in 77% of cases and all therapies were well tolerated. Serum immunoglobulin G levels did not differ before and after treatment. However, serum gastrin and pepsinogen group A levels were found to be significantly lower after eradication, suggesting that these values may provide a noninvasive means of verifying H pylori eradication. © 1993 Excerpta Medica, Inc. All rights reserved.