Successful low-dose amoxycillin, metronidazole and omeprazole combination therapy in a population with a high frequency of metronidazole- resistant Helicobacter pylori

T. Breuer, J. G. Kim, I. E. Gurer, D. P. Graham, M. Osato, R. M. Genta, D. Y. Graham

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Aim: Effective anti-Helicobacter pylori therapies with few side-effects are needed. We studied the effectiveness of a low-dose combination of metronidazole, amoxycillin and omeprazole for treatment of ulcer patients in Seoul, Korea. Methods: Patients with gastric or duodenal ulcer received metronidazole (125 mg b.d.), amoxycillin (500 mg b.d.) and omeprazole (20 mg at bedtime) for 2 weeks. Endoscopic examinations were performed before treatment and at least 6 weeks after completion of antimicrobial therapy. H. pylori status was confirmed by histological examination of two gastric biopsies using the Genta stain. Results: Seventy-nine patients (64 men, 15 women, mean age 46 years) with peptic ulcer were enrolled. H. pylori infection was cured in 56 (71%, 95%, CI: 60-81%). The cure rate in non- smokers was significantly higher than in smokers (88% vs. 65%, P= 0.035). Twelve pre-treatment isolates were available and metronidazole resistance was noted in all; H. pylori infection was cured in 10. Thirty-six patients cured of H. pylori have been followed for 1 year (mean of 361 days) and 2 cases became reinfected (5.5%, 9 5% CI: 1-18%). Conclusions: The low-dose combination of metronidazole, amoxycillin and omeprazole was effective even in the face of metronidazole resistance. Recurrence of H. pylori infection is infrequent even in countries with a high prevalence of H. pylori infection.

Original languageEnglish (US)
Pages (from-to)523-527
Number of pages5
JournalAlimentary Pharmacology and Therapeutics
Issue number3
StatePublished - Jan 1 1997


ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

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