Addition of bismuth subnitrate to omeprazole plus amoxycillin improves eradication of Helicobacter pylori.

Abstract

OBJECTIVE:

To evaluate whether the addition of bismuth subnitrate to a dual oral therapy regimen with omeprazole plus amoxycillin could improve Helicobacter pylori eradication.

METHODS:

Fifty consecutive Helicobacter pylori-positive patients were randomly enrolled to receive either (A) bismuth subnitrate (300 mg q.d.s.), omeprazole (20 mg b.d.) and amoxycillin (500 mg q.d.s.), or (B) omeprazole (20 mg b.d.) and amoxycillin (500 mg q.d.s.). Both groups (n=25 each) received the medication for 14 days. H. pylori status was reassessed 30 days after completion of the therapy in order to evaluate eradication rates.

RESULTS:

Six patients were lost to follow-up and therefore excluded from the study (three patients from each group). One patient from Group B withdrew from the study because of side-effects. The addition of bismuth subnitrate to omeprazole and amoxycillin significantly improved its efficacy in eradicating H. pylori, with 72% (18/25) eradication in Group A and 52% (13/25) in Group B (P=0.027). The addition of bismuth subnitrate to dual oral therapy was also capable of improving the healing of peptic ulcers when compared with dual oral therapy alone (100%, 8/8 vs. 58%, 4/7; P=0.021).

CONCLUSION:

Our results demonstrate that the addition of bismuth subnitrate to dual oral therapy enhances H. pylori eradication, and improves healing of peptic ulcers.

• Authors: A F Carvalho, L A Fiorelli, V N Jorge, C M Da Silva, G De Nucci, J G Ferraz, J Pedrazzoli
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 12 Issue 6 Pg. 557-61 (Jun 1998) ISSN: 0269-2813 [Print] England
• PMID: 9678816 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Ulcer Agents
• Penicillins
• ranitidine bismuth citrate
• Amoxicillin
• Ranitidine
• Omeprazole
• Bismuth

Topics

• Adult
• Aged
• Amoxicillin (administration & dosage, adverse effects, therapeutic use)
• Anti-Ulcer Agents (administration & dosage, adverse effects, therapeutic use)
• Bismuth (administration & dosage, adverse effects, therapeutic use)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Gastroscopy
• Helicobacter Infections (drug therapy, microbiology)
• Helicobacter pylori
• Humans
• Male
• Middle Aged
• Omeprazole (administration & dosage, adverse effects, therapeutic use)
• Penicillins (administration & dosage, adverse effects, therapeutic use)
• Ranitidine (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Stomach Ulcer (drug therapy, microbiology)