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Antibiotic Combinations Only Partially Effective For Helicobacter Pylori

Various combination therapies with omeprazole, azithromycin, amoxicillin and tinidazole appear to be only partially effective in treating patients with Helicobacter pylori.

Clinicians at the Hellenic Air Force and Veterans General Hospital in Athens, Greece, studied whether omeprazole plus azithromycin, and in association with either amoxicillin or tinidazole, is effective in curing infection among dyspeptic patients They point out that many combinations of antibiotics have been used in an attempt to find the optimal regimen for H. pylori eradication, Azithromycin, for example, is a macrolide that achieves high concentrations in gastric tissue after a single 500-mg oral dose.

A cohort of 160 consecutive symptomatic patients was assigned to receive omeprazole 20 mg twice daily for one week and azithromycin 500 mg/d for three days. In addition, 80 of the patients were randomly assigned to amoxicillin 1g twice daily (OAzAm group) for one week, and 80 patients to receive tinidazole 500 mg twice daily for three days (OAzT group). Their status was assessed by rapid urease test and histology at entry, and by histology and C-urea breath test after the end of the therapy.

The clinicians found that H pylori was eradicated in 62.5% of patients in the OAzAm group (intention to treat [ITT] 62.5%) and in 71.2% of patients in the OAzT group (ITT 71.2%).

"Although the compliance was excellent and the side effects negligible, the regimens used were partially effective for the eradication of H pylori," they conclude.
J Clin Gastroenterol 2003 Apr;36:4:325-8. "Omeprazole Plus Azithromycin and Either Amoxicillin or Tinidazole for Eradication of Helicobacter pylori Infection"

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