Amoxicillin—Omeprazole Treatment for Eradication of Helicobacter pylori

Labenz, Joachim; Gyenes, E; Rühl, G. H.; Börsch, G

doi:10.1007/978-3-642-77486-7_62

Cited by 9 publications

(5 citation statements)

References 4 publications

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“…Discussion 0830 During omeprazole treatment, the median 24 hour pH values in the Hpylori positive subjects wr were appreciably higher than in the H pylori hin negative subjects. The difference was evident during the entire recording, except for mealtime periods, but was most noticeable during the nocturnal part of the recording.…”

Section: Resultsmentioning

confidence: 97%

Effect of Helicobacter pylori status on intragastric pH during treatment with omeprazole.

Verdú¹,

Armstrong²,

Fraser³

et al. 1995

Gut

185

121

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To test the hypothesis that Helicobacter pylon1 infection is associated with a decreased intragastric acidity during omeprazole therapy, ambulatory 24 hour dual point gastric pH recordings were performed in 18 H pyloni positive and 14 H pylori negative subjects. There was a four to six week washout period between the two pH recordings made in each subject after one week courses of placebo or omeprazole, 20 mg daily. During placebo, median 24 hour pH values were not different in the corpus (H pylori positive=1.5, negative=1-4; p=0*9) or antrum (H pyloni positive= 13, negative= 12; p=0 1). However, during omeprazole treatment, median 24 hour pH values were higher in H pylori positive subjects, both in the corpus (H pylori positive=5 5, negative=4*0; p=0.001) and antrum (H pylorn positive=5.5, negative=3.5; p=0.0004). During placebo treatment, the only difference between the two groups was a higher later nocturnal pH in the antrum in the H pylorn positive group. During omeprazole treatment, gastric pH was higher both in the corpus and in the antrum in the H pylon positive group for all periods, except for mealtime in the corpus. These data indicate that omeprazole produces a greater decrease in gastric acidity in subjects with H pylon infection than in those who are H pylon negative. It is not, however, known whether there is a causal relationship between H pylorn infection and increased omeprazole efficacy. (Gut 1995; 36: 539-543) Keywords: Acid inhibition, Helicobacter pylori, omeprazole, intragastric pH-metry.Omeprazole has been shown to have both direct1 and indirect23 effects on Helicobacter pylori, but it is not known whether infection with the organism may itself influence gastric acidity during omeprazole therapy. It has been reported that during treatment with omeprazole, the intragastric pH is higher in patients with duodenal ulceration than in healthy controls.4 5 It is unclear whether this reduction in gastric acidity is observable in all subjects with H pylori infection, or whether it is confined to a subset of patients who develop peptic ulceration. If the increased susceptibility to omeprazole is related solely to Hpylori infection then Hpyloni negative subjects and H pylori positive subjects without ulceration should show different degrees of acid suppression in response to an equal dose of omeprazole.To test the hypothesis that Hpylori infection is associated with decreased intragastric acidity during treatment with omeprazole, we have conducted gastric pH-metry in H pylori positive individuals and compared the pH data with those obtained previously in 14 H pylori negative individuals. Methods SUBJECTSFourteen H pylon negative healthy subjects (seven men and seven women, age range: 22-46 years) and 18 H pylori positive subjects (1 1 men and seven women, age range: 22-45 years) were studied. Students and employees of a university hospital who had volunteered for an H pylori screening programme were also invited to participate in the present study. H pylori status was determined using the ...

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Section: Resultsmentioning

confidence: 97%

Effect of Helicobacter pylori status on intragastric pH during treatment with omeprazole.

Verdú¹,

Armstrong²,

Fraser³

et al. 1995

Gut

185

121

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“…Whether the timing of amoxicillin intake might be important remains uncertain, and available data are conflicting. A cure rate of 80% has been reported with dosing after the meals [137], but recently it was shown that taking amoxicillin suspension after meals decreased efficacy [71]. Some reports suggest that pretreatment with omeprazole impairs efficacy of dual therapy [86,134].…”

Section: Pp1 Dual Therapymentioning

confidence: 99%

Treatment of Helicobacter pylori Infection: A Review of the World Literature

et al. 1996

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“…Bayerdörffer et al 15 reported an 82% eradication rate for a regimen of omeprazole 40 mg once daily and amoxycillin 1 g twice daily given for 10 days. In Germany, 16 , 17 omeprazole 40 mg once daily and amoxycillin 500 mg four times daily for 4 weeks is recommended as standard therapy for H. pylori infection. This treatment regimen is associated with a low incidence of side effects, but eradication rates remain between 50–80%.…”

Section: Discussionmentioning

confidence: 99%

A prospective randomized study of amoxycillin and omeprazole with and without metronidazole in the eradication treatment of Helicobacter pylori

Koizumi

Tanabe

Hibi

et al. 1998

J of Gastro and Hepatol

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A combination of amoxycillin and omeprazole is often used to treat Helicobacter pylori infection. A three-drug regimen comprising metronidazole, amoxycillin and omeprazole has been proposed as an alternative therapy. In a prospective, randomized, comparative study, we evaluated these two regimens with respect to safety and efficacy in patients with H. pylori infection. Sixty patients with peptic ulcer (gastric, 32 patients; duodenal, 28 patients) who had a history of ulcer recurrence were randomly assigned to dual therapy with amoxycillin (500 mg three times daily for 2 weeks) and omeprazole (20 mg once daily for 8 weeks) or to triple therapy with metronidazole (500 mg twice daily for 2 weeks) plus amoxycillin and omeprazole, given in the same dosages as dual therapy. Forty-eight patients completed the protocol; treatment was discontinued because of side effects in nine patients, and three patients dropped out of the study. On the basis of all patients treated, the rate of H. pylori eradication was significantly higher for triple therapy 20/23 cases, 87.0%; 95% confidence interval (CI), 0.664-0.972) than for dual therapy 13/25, 52.0%; 0.313-0.722; P < 0.05). On an intention-to-treat basis, the difference between the groups in the rate of H. pylori eradication was marginally significant (P = 0.06 [0.028-0.512]). Side effects were reported by five patients receiving triple therapy (skin rash, one; nausea, two; headache, one; abdominal pain, one), and four patients receiving dual therapy (skin rash, two; abdominal pain, one; diarrhoea, one). All side effects resolved spontaneously after termination of treatment. There was no significant difference in safety between the two regimens. Triple therapy with metronidazole, amoxycillin, and omeprazole was significantly more effective for the eradication of H. pylori than dual therapy with amoxycillin and omeprazole alone. The safety of these regimens was similar, and triple therapy was found to be clinically acceptable.

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Amoxicillin—Omeprazole Treatment for Eradication of Helicobacter pylori

Cited by 9 publications

References 4 publications

Effect of Helicobacter pylori status on intragastric pH during treatment with omeprazole.

Effect of Helicobacter pylori status on intragastric pH during treatment with omeprazole.

Treatment of Helicobacter pylori Infection: A Review of the World Literature

A prospective randomized study of amoxycillin and omeprazole with and without metronidazole in the eradication treatment of Helicobacter pylori

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