K. Kiyota et al., Comparison of 1-week and 2-week triple therapy with omeprazole, amoxicillin, and clarithromycin in peptic ulcer patients with Helicobacter pylori infection: results of a randomized controlled trial, J GASTRO, 34, 1999, pp. 76-79
This study was a comparison of 1-week and 2-week triple therapies with omep
razole, amoxicillin, and clarithromycin (OAC) in patients with peptic ulcer
disease and helicobacter pylori infection. A total of 147 peptic ulcer pat
ients with H. pylori infection assessed by histology and culture were rando
mly treated with omeprazole 20mg bid + amoxicillin 1000mg bid + clarithromy
cin 400mg bid for either 1 week (OAC1w) or 2 weeks (OAC2w). Both groups the
n received omeprazole 20mg daily for 2 weeks followed by ranitidine 300mg d
aily for 4 weeks. Eradication of Ii. pylori was assessed by histology, cult
ure, and the C-13-urea breath test (C-13-UBT) at least 4 weeks after cessat
ion of antimicrobial therapy. Intention-to-treat eradication rates were 78.
2% (95%CI69%-87%) with OAC1w and 88.4% (95%CI81%-96%) with OAC2w. Per-proto
col eradication rates were 86.0% (95%CI78%-94%) with OAC1w, 97.0% (95%CI93%
-100%) with OAC2w. There was no significant difference in the eradication r
ates between QAC1w and OAC2w, Side effects were mild and self-limiting in b
oth groups. In conclusion, both 1- and 2-week triple therapy with OAC are w
ell tolerated and provide good eradication rates in peptic ulcer patients i
n Japan. The eradication rate of the 2-week regimen was higher than that of
the 1-week regimen, but the difference was not statistically significant.
Further studies including long-term economic considerations are required to
determine the optimal duration of treatment.