Quadruple therapy for symptomatic spontaneous duodenal ulcer disease
M C Bateson
Department of
Medicine, Bishop Auckland General Hospital, Cockton Hill Road, County
Durham, DL14 6AD, UK
Correspondence to: Dr Bateson
Submitted 3
August 2000;
Accepted 17 October 2000
AIM
To investigate
Helicobacter pylori eradication in duodenal
ulcer patients with a new regimen, lansoprazole 30 mg daily for one or
four weeks plus twice daily tetracycline 500 mg, clarithromycin 250 mg,
and metronidazole 400 mg.
BACKGROUNDSpontaneous duodenal
ulcer is regularly associated with H pylori,
and permanent cure follows eradication of this bacterium. Numerous
treatments have been proposed and none is ideal, possibly because of
primary or acquired antibiotic resistance. Quadruple regimens with
proton pump inhibitor therapy and three antibiotics offer promise as
the most effective therapy.
METHODSFrom November 1995 all
patients with spontaneous duodenal ulcer were offered quadruple
therapy. A month after completion a carbon 14 urea breath test (UBT)
was performed. Sensitivity of H pylori to
the antibiotics used was tested in 1992-3, 1996, and 1999.
RESULTSA total of 331 patients
were treated; 313 attended for a UBT, of which 299 were negative
(95.5%). Of those patients who had an endoscopy with positive urease
test immediately before treatment, 95/101 (94.0%) on lansoprazole for
one week and 116/121 (95.8%) on lansoprazole for four weeks had a
negative UBT. H pylori antibiotic sensitivity did not change.
CONCLUSIONThis regimen produced
some of the best results yet seen and may be generally recommended as
first line therapy.
Keywords: Helicobacter pylori; duodenal ulcer
© 2001 by The Fellowship of Postgraduate Medicine
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
