One week eradication regimen for Helicobacter pylori

• Published in: The Lancet (British edition) 1991-11, Vol.338 (8777), p.1249-1252
• Main Authors: Logan, R.P.H., Gummett, P.A., Misiewicz, J.J., Karim, Q.N., Walker, M.M., Baron, J.H.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Amoxicillin; Amoxicillin - administration & dosage; Anti-Ulcer Agents - administration & dosage; Biological and medical sciences; Digestive system; Drug Administration Schedule; Drug Combinations; Drug Resistance, Microbial; Drugs; Dyspepsia; Eradication; Female; Follow-Up Studies; Gastritis; Helicobacter Infections - diagnosis; Helicobacter Infections - drug therapy; Helicobacter pylori; Helicobacter pylori - drug effects; Helicobacter pylori - isolation & purification; Humans; Male; Medical disorders; Medical research; Medical sciences; Metronidazole; Metronidazole - administration & dosage; Middle Aged; Organometallic Compounds - administration & dosage; Patient Compliance; Patients; Pharmacology. Drug treatments; Pyloric Antrum - microbiology; Time Factors; Ulcers
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/0140-6736(91)92111-E

Although Helicobacter pylori is both a frequent cause of gastritis and an important factor in duodenal ulcer recurrence, no treatment regimen exists that is completely safe and effective. We have studied a short eradication regimen of tripotassium dicitrato bismuthate 120 mg four times daily and amoxycillin 500 mg four times daily for seven days with metronidazole 400 mg five times daily for three days (days 5-7). 106 patients with peptic ulceration and non-ulcer dyspepsia, who were also infected with H pylori,were entered into the study. H pylori was successfully eradicated in 76/106 (72%) patients (median follow-up 9·3 months). The rate of eradication was higher among patients with metronidazole-sensitive H pylori (40/43, 93%). In 17/30 patients in whom eradication failed, pretreatment metronidazole-resistant strains were subsequently isolated. Side-effects were mild, the commonest (24/106, 24%) being taste disturbance with metronidazole. A one-week eradication regimen is a safe, effective, cheap, and well-tolerated treatment for metronidazole-sensitive H pylori.