Helicobacter pylori感染に対するamoxicillin, clarithromycin, proton pump inhibitorによる短期3剤併用療法の検討

抄録

Efficacy of one week triple therapy with amoxicillin (1,500mg/day) , clarithromycin (800mg/day) , and lansoprazole (60mg/day) or omeprazole (40mg/day) for 61 patients with Helicobacter pylori infection was investigated. Diagnosis of H pylori infection was based on the result of rapid urease test, and eradication of H pylori was assessed by culture and Giemsa staining of antral as well as corporeal biopsy specimens 6-8 weeks after the cessation of the eradication therapy. Three patients were dropped out from the therapy due to side effects, such as diarrhea or urticaria.
H pylori eradication was observed in 28/36 (78%) in patients with gastric ulcer, 16/17 (94%) with duodenal ulcer, and 5/5 (100%) with chronic gastritis. Overall eradication rate was 49/84 (84%) . Lansoprazole has been reported to be about 4 times stronger against H pylori than omeprazole in vitro, however in the present study eradication rate with lansoprazole and omeprazole were similar (82% vs 89%) . Recurrence of gastric ulcer was observed in a patient after success of eradication of H pylori, and the reasons of ulcer recurrence were smoker and night worker. A week triple therapy with amoxicillin, clarithromycin, and proton pump inhibitor was considered to be promising with good compliance.