Low Dose Amoxicillin, Metronidazole, and Omeprazole Therapy for Peptic Ulcer

Kim, Jae Seon; Bak, Young Tae; Kim, Jin Ho; Kim, Jong Guk

Abstract

BACKGROUND/AIMS: Anti-Helicobacter pylori(H. pylori) therapies with few side effects are needed. We studied the effectiveness of low dose combination of amoxicillin, metronidazole, and omeprazole for treatment of ulcer patients.
METHODS
Patients with gastric or duodenal ulcer received amoxicillin(500 mg b.I.d.), metronidazole(125 mg b.I.d.), aod omeprazole(20 mg at bedtime) for 2 weeks. Endoscopic examinations were perforrned before treatment and at 4 weeks, 3 months, 6 months, 9 months and 1 year after ending antimicrobial therapy. H. pylori status was confirmed by CLO test.
RESULTS
91 patients(72 men and 19 women) with a mean age of 45.2 years(range 19-81) were enrolled. There were 54 Dus, 32 Gus, and 5 with both. At 2 weeks, the compliance rate was 100%, and no side effects was noted. Of 69 patients(40 Dus, 25 Gus, and 4 with both) who had undergone endoscopy at 4 weeks after ending antimicrobial therapy, the ulcer healed in 55 patients(34 Dus, 19 Gus, and 2 with both), and H. pylori infection was cured in 49 patients(27 Dus, 19 Gus, and 3 with both). And so the healing rate of ulcer and cure rate of H, pylori at 4 weeks after ending antimicrobial therapy was 79.7%(DU 85.0%, GU 76.0%, and Both 50%) and 71.0%(DU 67.5%, GU 76.0%, Both 75%) respectively. 28(18 Dus, 9 Gus, and 1 Both) of the healed ulcer patients in whom H. pylori had been cured had been followed respectively up for 1 year; ulcer recurrence and H. pylori reoccurrence were 2(1 DU, 1 GU) and 3(1 DU, 2 Gus), thus ulcer recurrence and H. pylori reoccurrence was 7.1% and 10.7%, respectively. 8 patients(7 Dus, 1 GU) of the healed ulcer patients in whom H. pylori had not been cured were followed up during 1 year; there were 6 ulcer recurrences(6 Dus), and so ulcer recurrence was 75.0%, but natural eradication of H. pylori was not.
CONCLUSIONS
The combination of amoxicillin, metronidazole, and omeprazole even at the low dose prescribed may be one of an effective therapy regimen with excellent compliance rate for peptic ulce.r.