Omeprazole, azithromycin and either amoxycillin or metronidazole in eradication of Helicobacter pylori in duodenal ulcer patients

• Published in: Alimentary pharmacology & therapeutics 1998-05, Vol.12 (5), p.453-456
• Main Authors: VCEV, A, VCEVA, A, STIMAC, D, TAKAC, B, DMITROVIC, B, KOVAC, D
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Amoxicillin - therapeutic use; Anti-Bacterial Agents - therapeutic use; Anti-Ulcer Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Azithromycin - therapeutic use; Biological and medical sciences; Digestive system; Duodenal Ulcer - drug therapy; Duodenal Ulcer - microbiology; Female; Helicobacter Infections - drug therapy; Helicobacter Infections - microbiology; Helicobacter pylori; Humans; Male; Medical sciences; Metronidazole - therapeutic use; Middle Aged; Omeprazole - therapeutic use; Penicillins - therapeutic use; Pharmacology. Drug treatments
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1046/j.1365-2036.1998.00332.x

Background Azithromycin is a new generation, acid stable, macrolide antibiotic that achieves remarkably high concentrations in gastric tissue (above the minimal inhibitory concentration for Helicobacter pylori) after oral administration. Aim To establish whether azithromycin plus omeprazole in association with either amoxycillin or metronidazole are useful in curing H. pylori infection in patients with a duodenal ulcer. Methods One hundred patients with active duodenal ulcers and H. pylori infection were treated with omeprazole (days 1–10, 40 mg b.d.; days 11–24, 40 mg o.m.; days 25–42, 20 mg o.m.) plus azithromycin 500 mg o.m. for the first 6 days. Patients were randomly assigned to receive either amoxycillin 1 g b.d. (OAzA group; n = 50) or metronidazole 400 mg t.d.s. (OAzM group; n = 50) during the first 10 days of treatment. H. pylori status was determined by urease test and histology before the treatment and 6 weeks after completion of therapy. Results Ninety‐seven patients completed the study. H. pylori infection was eradicated in 85% (41/48) of patients in the OAzA group (intention‐to‐treat analysis 82%) vs. 74% (36/49) of patients in the OAzM group (intention‐to‐treat analysis: 72%) (N.S.). All ulcers had healed after 6 weeks of omeprazole treatment. Side‐effects, usually minor, were recorded in 13% (OAzA group) and 47% (OAzM group) of patients (P