Effect of treatment with lansoprazole and amoxicillin in combination on healing process of duodenal ulcer.

The important role of Helicobacter pylori (H. pylori) in idiopathic duodenal ulcer disease is widely acknowledged. Treatment with amoxicillin and omeprazole has been highly successful in eradicating H. pylori in some pilot studies. We conducted a study in patients with active duodenal ulcer disease and H. pylori colonization of gastric mucosa using a combination of amoxicillin and lansoprazole. Lansoprazole has been shown to exhibit lower MIC than omeprazole. Sixty three patients who qualified for admission to the study were randomly assigned to receive either oral lansoprazole (30 mg, p.o., qam, daily for 6 weeks) (n = 30) or lansoprazole (6 weeks) plus amoxicillin (1500 mg, p.o, t.i.d., daily for 2 weeks) (n = 33). Six weeks after the initiation of treatment with lansoprazole, healing of the ulcers was assessed using electronic endoscope according to the classification of Sakita & Miwa. When lansoprazole alone was administered to the patients, H. pylori dormancy was attained in none of the patients, whereas dormancy was ascertained in 17 out of 33 patients when lansoprazole and amoxicillin were administered in combination. H. pylori dormancy was assessed by 13C urea breath test, histological examination of gastric mucosa and rapid urease test. Endoscopic evaluations revealed that S2/S1 ratio was significantly higher in patients with H. pylori dormancy than in those without. The results of our study confirmed that treatment to eradicate H. pylori with drugs such as lansoprazole and amoxicillin is effective in the healing of idiopathic duodenal ulcer disease.