Is a 7-day Helicobater pylori treatment enough for eradication and inactivation of gastric inflammatory activity?

World J Gastroenterol. 2008 May 14;14(18):2838-43. doi: 10.3748/wjg.14.2838.

Abstract

Aim: To compare the efficacy of a 7-d vs 10-d triple therapy regarding H pylori eradication, endoscopic findings and histological gastric inflammatory inactivation in the Ecuadorian population.

Methods: 136 patients with dyspepsia and H pylori infection were randomized in 2 groups (68 per group): group 1, 7-d therapy; group 2, 10-d therapy. Both groups received the same medication and daily dosage: omeprazole 20 mg bid, clarithromycin 500 mg bid and amoxicillin 1 g bid. Endoscopy was performed for histological assessment and H pylori infection status before and 8 wk after treatment.

Results: H pylori was eradicated in 68% of group 1 vs 83.8% of group 2 for the intention-to-treat analysis (ITT) (P = 0.03; OR = 2.48; 95% CI, 1.1-5.8), and 68% in group 1 vs 88% in group 2 for the per-protocol analysis (PP) (P = 0.008; OR = 3.66; 95% CI, 1.4-10). Endoscopic gastric mucosa normalization was observed in 56.9% in group 1 vs 61.2% in group 2 for ITT, with similar results for the PP, the difference being statistically not significant. The rate of inflammatory inactivation was 69% in group 1 vs 88.7% in group 2 for ITT (P = 0.007; OR = 3.00; 95% CI, 1.2-7.5), and 69% in group 1 vs 96% in group 2 for PP (P = 0.0002; OR = 7.25; 95% CI, 2-26).

Conclusion: In this Ecuadorian population, the 10-d therapy was more effective than the 7-d therapy for H pylori eradication as well as for gastric mucosa inflammatory inactivation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Amoxicillin / pharmacology
  • Amoxicillin / therapeutic use*
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Ulcer Agents / pharmacology
  • Anti-Ulcer Agents / therapeutic use*
  • Biopsy
  • Clarithromycin / pharmacology
  • Clarithromycin / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Ecuador
  • Female
  • Gastric Mucosa / drug effects
  • Gastric Mucosa / microbiology
  • Gastric Mucosa / pathology
  • Gastritis / drug therapy*
  • Gastritis / microbiology
  • Gastritis / pathology
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / microbiology
  • Helicobacter Infections / pathology
  • Humans
  • Male
  • Middle Aged
  • Omeprazole / pharmacology
  • Omeprazole / therapeutic use*
  • Prospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anti-Ulcer Agents
  • Amoxicillin
  • Clarithromycin
  • Omeprazole