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Keywords:

  • amoxicillin/administration and dosage;
  • combination;
  • drug therapy;
  • Helicobacter pylori/drug therapy;
  • proton pump inhibitors/administration and dosage

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Triple therapy using a proton pump inhibitor with two antibiotics is the standard treatment for H. pylori infection. However, the increasing prevalence of antibiotic resistance has eroded the high success rates initially reported for the standard triple therapy.

WHAT THIS STUDY ADDS

• Compared with standard triple therapy, amoxicillin/lansoprazole dual therapy, given three times daily for H. pylori had a similar eradication rate with fewer side effects.

AIM

We compared three times daily dual therapy with standard triple therapy for effectiveness and safety in H. pylori infection.

METHODS

Two hundred and four H. pylori positive patients with peptic ulcer were randomly assigned to one of two regimens: (i) triple therapy with amoxicillin, clarithromycin and lansoprazole twice daily for 2 weeks or (ii) dual therapy with amoxicillin and lansoprazole three times daily for 2 weeks. The success of eradication was evaluated 4 to 5 weeks after completing treatment.

RESULTS

The eradication rate was 82.8% in the triple therapy group and 78.4% in the dual therapy group by per protocol analysis. This difference was not significant (P= 0.573). Adverse events were more frequent in the triple therapy group than in the dual therapy group (P= 0.002).

CONCLUSIONS

Because dual therapy had fewer side effects than triple therapy and a similar eradication rate, dual therapy may provide an acceptable alternative first line therapy for H. pylori eradication in Korea.