Omeprazole plus clarithromycin: efficacy of two treatment regimens on Helicobacter pylori positive duodenal ulcer

Helicobacter pylori has been identified as a major factor in duodenal ulcerogenesis. As infectious disease, duodenal ulcer must be treated with a combination of an antimicrobial agent with omeprazole. Thus our aim was to find the most effective dose of clarithromycin plus omeprazole.We selected 130 patients with duodenal ulcer Helicobacter pylori positive randomly assigned to receive omeprazole 40 mg daily plus clarithromycin 1.5 g daily (A Group) or omeprazole 40 mg daily plus clarithromycin 1 g daily (B Group). At 8 weeks after the end of therapy 100% patients in A Group and 95.3% in B Group were healed (ns), 86% in A Group and 87% in B Group were eradicated (ns). At 6 months none of the patients in A and in B Group had duodenal ulcer relapse, 81% in A Group and 78% in B Group were eradicated (ns). Helicobacter pylori eradication induced an improvement in gastritis grade by the decrease of the number of patients with more severe grade up to 6 month follow-up. There were no statistical differences between the two groups. In conclusion we prefer omeprazole 40 mg daily plus clarithromycin 1 g daily as first choice treatment of duodenal ulcer because patient compliance is better and side effects are nearly absent.