Omeprazole supports H. pylori eradication better than ranitidine

המידע באדבות מדיקונטקסט
Last Updated: 2001-07-13 15:15:37 EDT (Reuters Health)

By Will Boggs, MD

WESTPORT, CT (Reuters Health) – In combination with antibiotics, omeprazole is more effective than ranitidine in eradicating Helicobacter pylori in the setting of duodenal ulcers, according to a report in the June issue of the European Journal of Gastroenterology & Hepatology.

Although most experts recommend the use of a proton pump inhibitor in combination with antibiotics in treating patients with gastric or duodenal ulcers and H. pylori infection, data also support the use of H2 receptor antagonists as antisecretory medications, the authors explain.

Dr. Wolfgang Moser, from Biochemie Austria, in Kundl, Austria, and colleagues in the AMOR Study Group compared, for the first time, the effects of omeprazole and ranitidine in combination with antibiotics (amoxicillin and metronidazole) in the treatment of H. pylori-related duodenal ulcer.

H. pylori eradication was significantly higher in the omeprazole group (87%) than in the ranitidine group (77%), the authors report. Similar differences were seen when metronidazole-sensitive and metronidazole-resistant H. pylori eradication rates were examined separately.

Eradication rate differences did not translate into significant differences in clinical ulcer healing rates, the results indicate, though the omeprazole patients reported a slightly quicker reduction in pain than did the ranitidine patients.

Gastritis score improvements, however, were markedly better in patients who received successful H. pylori eradication than in those who did not, the researchers note.

Tolerance for the two drugs was similar, the report indicates, and side effects occurred with more or less equal frequency in the two treatment groups.

"The faster onset of action and the higher potential of acid inhibition of the proton pump inhibitors (PPIs) compared to the H2-antagonists seem to be responsible for the better efficacy of amoxicillin and therefore for the better eradication rates," Dr. Moser told Reuters Health. "Nevertheless, the amount of acid inhibition…with H2-antagonists seems to be enough to achieve the same ulcer-healing rates 4 weeks after therapy as with PPIs."

"H. pylori eradication therapy with omeprazole, amoxicillin, and metronidazole for 7 days has an excellent efficacy and tolerability," Dr. Moser concluded. "PPIs are the preferable combination-partners compared to H2-antagonists."

Eur J Gastroenterol Hepatolol 2001;13:685-691.

-Westport Newsroom 203 319 2700

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