Dual versus triple therapy of Helicobacter pylori infection: results of a multicentre trial

• DOI: 10.1136/adc.81.1.68
• Publication Date: 2009-01-07T21:17:23Z
• Authors: R. Behrens; T. Lang; K. M Keller; L. Bindl; M. Becker; B. Rodeck; P. Kuster; G. F Wundisch; M. Stolte
• Keywords: Male; Adolescent; Helicobacter pylori; Amoxicillin; Anti-Ulcer Agents; Helicobacter Infections; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Child, Preschool; Clarithromycin; Humans; Drug Therapy, Combination; Female; Prospective Studies; Child; Omeprazole

To compare dual therapy (omeprazole and amoxicillin) with triple therapy (omeprazole, amoxicillin, and clarithromycin) in the treatment of Helicobacter pylori infection. The efficacy of 1 mg/kg/day omeprazole was randomly compared with 2 mg/kg/day.252 patients (median age, 11.0 years; range, 3-18) presenting with chronic abdominal pain underwent endoscopy and a 13C-urea breath test. Gastric biopsy specimens were taken for histological examination and for the rapid urease test. Patients were treated for two weeks: group A (n = 63) received amoxicillin (50 mg/kg; maximum, 2 g/day), group B (n = 73) received amoxicillin and clarithromycin (20 mg/kg; maximum, 1 g/day). Both groups were randomly treated with either 1 or 2 mg/kg omeprazole (maximum, 80 mg/day). Diagnostic procedures were repeated four weeks after the end of treatment.11 patients were excluded; 136 patients were H pylori positive (56%), 105 of whom were re-examined after treatment. Helicobacter pylori was eradicated in 52% of group A and 83% of group B. The dose of omeprazole had no influence on the eradication rate. Specificity and sensitivity of the rapid urease test were 94% and 93%, respectively. Specificity and sensitivity of the 13C-urea breath test were 93% and 95%, respectively.Dual therapy can no longer be recommended. Triple therapy is more effective than dual therapy in the eradication of H pylori infection. The lower dose of 1 mg/kg omeprazole was as effective as 2 mg/kg.