Omeprazole, amoxycillin and metronidazole for the cure of Helicobacter pylori infection

• Published in: European journal of gastroenterology & hepatology Vol. 11 Suppl 2; p. S19
• Main Authors: Bayerdörffer, E, Lind, T, Díte, P, Bardhan, K D, O'Morain, C, Delchier, J C, Spiller, R, Veldhuyzen van Zanten, S, Sipponen, P, Mégraud, F, Zeijlon, L
• Format: Journal Article
• Language: English
• Published: England 01.08.1999
• Subjects: Amoxicillin - administration & dosage; Amoxicillin - therapeutic use; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Anti-Ulcer Agents - administration & dosage; Anti-Ulcer Agents - therapeutic use; Drug Therapy, Combination; Helicobacter Infections - drug therapy; Helicobacter pylori; Humans; Metronidazole - administration & dosage; Metronidazole - therapeutic use; Omeprazole - administration & dosage; Omeprazole - therapeutic use; Penicillins - administration & dosage; Penicillins - therapeutic use; Treatment Outcome
• ISSN: 0954-691X

In two studies, different regimens of omeprazole-amoxycillin-metronidazole were assessed for the eradication of Helicobacter pylori. Randomized, international, multicentre studies with parallel groups. The studies were performed at centres in Canada, Czech Republic, France, Germany, Hungary, Sweden and UK. H. pylori-positive patients with duodenal ulcer disease (active or in remission) were randomized to 7-day treatment with: omeprazole 40 mg once daily, amoxycillin 500 mg three times daily and metronidazole 400 mg three times daily (OAMtid; n = 242); omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily and metronidazole 800 mg twice daily (OAM800; n = 247); or omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily and metronidazole 400 mg twice daily (OAM400; n = 127). Eradication of H. pylori. Intention-to-treat analysis revealed H. pylori eradication rates of 76% (184/242) with OAMtid, 80% (198/247) with OAM800, and 76% (97/127) with OAM400. There was considerable variation in the levels of primary resistance to metronidazole in different countries. The overall eradication rate in patients infected with metronidazole-sensitive H. pylori strains was 85% (313/370), compared with 60% (56/94) in patients harbouring metronidazole-resistant strains (P<0.001). All regimens were generally well tolerated, with mild adverse events occurring in 4-26% of patients (mainly diarrhoea, reversible increase in liver enzymes and headache). The OAM combination is effective in curing H. pylori infection. Primary metronidazole resistance may reduce its effectiveness, but an increased daily dosing of metronidazole may partly overcome this problem.