Triple therapy with omeprazole, clarithromycin and amoxycillin for eradication of Helicobacter pylori infection

Objective To compare the efficacy of clarithromycin 500 mg and metronidazole 400 mg twice a day when they were combined with omeprazole amoxycillin for the eradication of Helicobacter pylori(Hp) .Methods 103 subjects with Hp associated peptic ulcer were divided into two groups.They accepted one week triple therapy with omeprazole 20?mg bid, amoxycillin 1?000?mg bid and either clarithromycin 500?mg bid (group A, n =58) or metronidazole 400?mg bid(group B, n =45).Patients with active peptic ulcer were treated with omeprazole 20?mg daily for 2 to 4 weeks after anti Hp therapy.Endoscopic examination with four biopsies (two specimens from the antrum and two from the gastric body) was performed.Two months after anti Hp therapy,endoscopy and gastric biopsies were reexaminated.Results The Hp eradication rates in Groups A and B were 89.3% (50/56) and 84.1% (37/44),there was no difference between them( P 0.05).The active ulcer healing rate was 96.7% (29/30) in Group A and 100% (21/21) in Group B.Six patients in group A (10.3%) and five in group B (11.1%) reported adverse events ( P 0.05).The active ulcer healing rate and adverse rate were found no differences between group A and group B( P 0.05).Conclusion One week triple therapy with omeprazole and amoxycillin in combination with either clarithromycin or metronidazole is effective for eradication of Hp .Metronidazole has the advantage of lower cost,good compliance and mild side effects,it may offer a good choice for treatment of peptic ulcer associated with Hp infection in clinical practice.