Journal of gastroenterology
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Eradication therapy for Helicobacter pylori is now common, since eradication of this organism reduces the recurrence rate of peptic ulcer. We evaluated the eradication of H. pylori 4 weeks after the cessation of eradication treatment, and encountered recolonization in patients in whom eradication had been confirmed. Using a urease probe, we analyzed the Ure B restriction fragment length polymorphism (RFLP) of the DNA of the recolonized H. pylori by Southern blotting and compared it with that of the H. pylori strain cultured before eradication therapy. RFLP patterns before and after the treatment were identical, indicating that the recolonization of H. pylori was an exacerbation of the primary infection, rather than a reinfection.
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Randomized Controlled Trial Comparative Study Clinical Trial
Significant increase in eradication rates of Helicobacter pylori infection with two consecutive dual therapies (omeprazole and amoxycillin or omeprazole and clarithromycin). A randomized study in 450 Spanish patients.
Helicobacter pylori infection is associated with peptic ulcer disease and chronic gastritis, and eradication of the microorganism markedly reduces the recurrence of peptic ulcer. However, a major problem is the choice of a treatment that is effective, has high eradication rate, and is well tolerated by patients. We evaluated the eradication of H. pylori infection in patients with chronic gastritis (CG), duodenal ulcer (DU), and gastric ulcer (GU) after two dual therapies (omeprazole with either amoxycillin or clarithromycin). ⋯ A second consecutive dual therapy of omeprazole plus an antibiotic (amoxycillin or clarithromycin) not used in the first therapy improved on the eradication rates obtained with the first regimen. The overall eradication rates were also higher, but no significant differences were found between amoxycillin and clarithromycin. The best results were obtained in those patients with GU.
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We reviewed reports on the efficacy of clarithromycin in eradicating Helicobacter pylori. Reports on dual and 1-week triple therapy that included clarithromycin were analyzed to assess the eradication rates of H. pylori infection. ⋯ Clarithromycin is useful for treatment of H. pylori infection. One-week triple therapy that includes clarithromycin and a proton pump inhibitor effectively eradicates H. pylori.