Randomised controlled trial of short term treatment to eradicate Helicobacter pylori in patients with duodenal ulcer

Shorland W. Hosking, Thomas K W Ling, Man Yee Yung, Augustine Cheng, Sydney C S Chung, Joseph Leung, Arthur K C Li

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129 Scopus citations

Abstract

Objective - To determine whether one week's drug treatment is sufficient to eradicate Helicobacter pylori in patients with duodenal ulcer. Design - Single blind, randomised controlled trial. Setting - Specialised ulcer clinic in a teaching hospital. Patients - 155 patients with H pylori and a duodenal ulcer verified endoscopically which had either bled within the previous 24 hours or was causing dyspepsia. Interventions - Patients were allocated randomly to receive either omeprazole for four weeks plus bismuth 120 mg, tetracycline 500 mg, and metronidazole 400 mg (all four times a day) for the first week (n=78), or omeprazole alone for four weeks (n=77). Further endoscopy was performed four weeks after cessation of all drugs. Main outcome measures - Presence or absence of H pylori (by urease testing, microscopy, and culture of antral biopsy specimens), duodenal ulcer, and side effects. Results - Eradication of H pylori occurred in 70 (95%) patients taking the four drugs (95% confidence interval 86% to 97%) compared with three (4%) patients taking omeprazole alone (1% to 11%). Duodenal ulcers were found in four (5%) patients taking the four drugs (2% to 12%) and in 16 (22%) patients taking omeprazole alone (14% to 32%). Mild dizziness was the only reported side effect (six patients in each group) and did not affect compliance. Conclusions - A one week regimen of bismuth, tetracycline, and metronidazole is safe and effective in eradicating H pylori and reduces the number of duodenal ulcers four weeks after completing treatment.

Original languageEnglish (US)
Pages (from-to)502-504
Number of pages3
JournalBritish Medical Journal
Volume305
Issue number6852
StatePublished - Aug 29 1992
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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    Hosking, S. W., Ling, T. K. W., Yung, M. Y., Cheng, A., Chung, S. C. S., Leung, J., & Li, A. K. C. (1992). Randomised controlled trial of short term treatment to eradicate Helicobacter pylori in patients with duodenal ulcer. British Medical Journal, 305(6852), 502-504.