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[Evaluation of the efficacy and the cost-effectiveness of proton pump inhibitor-based dual and triple therapy regimens for H. pylori eradication in peptic ulcer disease].

Abstract
To evaluate the efficacy and the cost-effectiveness of H. pylori eradication for the treatment of peptic ulcer disease, a randomized controlled trial to compare the efficacy of proton pump inhibitor-based dual and triple regimens was conducted. A decision analysis was also performed to assess H. pylori eradication compared to the conventional maintenance strategy. Two hundred and thirty-four peptic ulcer patients suffering from H. pylori infection were randomly treated with either omeprazole 20 mg bid + amoxicillin 500 mg qid + clarithromycin 400 mg bid (OAC) or with omeprazole 20 mg bid + clarithromycin 400 mg bid (OC) for 14 days. The eradication rate with OAC was 87.6% (92/105) (95% Confidence Interval (CI): 81-94%), which was significantly higher than that with OC (61.9% (60/97) (95% CI: 52-72%)) (p < 0.001, chi 2 test). Both regimens were safe and well tolerated. H. pylori eradication was more effective and less costly than conventional strategy in a long term perspective. OAC was more cost-effective than OC. In conclusion, H. pylori eradication is a cost-effective alternative to conventional treatment. We recommend 2 weeks triple regimen with omeprazole 20 mg bid + amoxicillin 500 mg qid + clarithromycin 400 mg bid (OAC) as a first-line treatment in all patients with peptic ulcers associated with H. pylori infection.
AuthorsY Habu, K Kiyota, H Inokuchi, Y Sugano, K Ko, S Waki
JournalNihon rinsho. Japanese journal of clinical medicine (Nihon Rinsho) Vol. 57 Issue 1 Pg. 135-9 (Jan 1999) ISSN: 0047-1852 [Print] JAPAN
PMID10036950 (Publication Type: Clinical Trial, English Abstract, Journal Article, Randomized Controlled Trial)
Chemical References
  • Anti-Ulcer Agents
  • Proton Pump Inhibitors
  • Amoxicillin
  • Clarithromycin
  • Omeprazole
Topics
  • Amoxicillin (administration & dosage)
  • Anti-Ulcer Agents (administration & dosage, economics)
  • Clarithromycin (administration & dosage)
  • Cost-Benefit Analysis
  • Drug Evaluation
  • Drug Therapy, Combination (administration & dosage)
  • Helicobacter Infections (drug therapy, microbiology)
  • Helicobacter pylori (isolation & purification)
  • Humans
  • Omeprazole (administration & dosage)
  • Peptic Ulcer (drug therapy, microbiology)
  • Proton Pump Inhibitors
  • Treatment Outcome

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