The role of omeprazole and antibiotic combinations in the eradication of Helicobacter pylori--an update

Abstract

When omeprazole is given with an appropriate antibiotic, a high rate of Helicobacter pylori eradication can be achieved. To date, most studies have used omeprazole and amoxycillin, and an analysis of the results suggests that, at present, the most effective treatment regimen comprises omeprazole, 20 mg twice daily, and amoxycillin, 1 g twice daily, for 14 days. This regimen provides an eradication rate of about 85%. Results using omeprazole plus bismuth or tetracycline have been disappointing; however, preliminary studies of omeprazole plus clarithromycin show promise, although further data are needed. Treatment with omeprazole plus two different antibiotics has also been used in a number of studies. The results thus far have been variable, although increases in the omeprazole dose/regimen might improve eradication rates. Moreover, one recent study that used omeprazole, a low dose of clarithromycin and tinidazole gave 100% H. pylori eradication after 1 week. If the effectiveness of this regimen is confirmed, it will prove to be the most effective treatment for the eradication of H. pylori identified to date.