Triple Therapy for Eradication of H. pylori in Patients with Peptic Ulcer

Lee, Kye Heui; Kim, Na Young; Ko, Young Hee; Ko, Jae Jung; Oh, Ju Hyun; Lee, Chang Gyun; Lim, Sun Hee

Abstract

BACKGROUND AND AIMS: This study was performed to find an ideal treatment regimen in the aspects of eradication of H. pylori, symptom reduction and side effects.
METHODS
Three hundred thirty four patients with peptic ulcer were randomized to receive two types of triple therapy: one includes colloidal bismuth subcitrate, metronidazole and tetracycline (BMT regimen), and the other includes omeprazole, amoxicillin and clarithromycin (OAC regimen). The BMT regimen was categorized into two types aceording to intake duration: 14 day (BMT 14) and 7 day (BMT 7) treatments, and the OAC regimen is categorized into three types: 14 day (OAC 14), 10 day (OAC 10) and 7 day (OAC 7) treatments. The degree of symptom reduction and frequency of the side effects were evaluated. Eradication rate was determined at least 4 weeks after the triple therapy.
RESULTS
The H. pylori eradication rate was 92.3% in BMT 14 group, 88.0% in BMT 7, 88.6% in OAC 14, 89.2% in OAC 10 and 85.2% in OAC 7. There was no significant difference in eradication rate among these five regimens. More than 50% of symptom reduction within 1 week was observed 95.9% in OAC regimen, and it was significantly higher than that of BMT regimen (84.4%, p<0.05). Two types of side effects were found (major and minor side effects). The major side effects implied the cases where the symptom was too serious for the treatment to continue. The percentages of all side effects in each group were as follows; 27.3% in BMT 14 (major 9.1%); 21.2% in BMT 7 (major 4.5%); 26.0% in OAC 14 (rnajor 1.9%); 13.0% in OAC 10 (no major); 20.3% in OAC 7 (no major).
CONCLUSIONS
The 7 day treatment regimen for both of the triple therapy was favorable, because the eradicatian rate almost remained as the same. The OAC 7 regimen, which is more expensive than BMT 7, gives the faster symptom reduction and the lower rate of the major side effect.