Is additional acid-suppressing agents needed after the initial Helicobacter pylori eradication therapy to heal peptic ulcers?

Jung, Jae Jin; Lee, Dong Wook; Lee, Dong Su; Chung, Kang Wook; Kim, Young Sung; Kim, Eun Young; Son, Soo Ho; Yeo, Jun Ki; Kwak, Dong Hyup

Abstract

BACKGROUND: Helicobacter pylori (H. pylori) can now be eradicated in the majority of patients with 7 days of treatment with OAC (omeprazole+amoxicillin+clarithromycin) regimen. It is unclear if additional acid-suppressing treatment should be continued beyond 7 days in patients with active gastric or duodenal ulcers.
METHODS
Ninety two patients with endoscopically proven active peptic ulcers who were H. pylori positive were randomized to receive either omeprazole 20 mg plus amoxicillin 1.0g plus clarithromycin 500mg ; twice daily for 1 week alone (OAC group) or same regimen followed by 3 weeks of omeprazole (OACP group). Endoscopy and UBT (urea breath test) were performed 8 weeks after the initiation of treatment.
RESULTS
Forty four of forty five (97.8%) of OAC group and forty four of forty seven (93.6%) of OACP group were noted to have healed ulcer at week 8.
CONCLUSION
In patients with H. pylori infection and peptic ulcers, one week of OAC therapy without further need for PPI may heal the ulcers. Following an l week course of H. pylori eradication therapy by OAC for peptic ulcers, further 3 weeks of acid-suppressing therapy with PPI was not proven to promote ulcer healing rate.