LONDON (Reuters Health) – Famotidine or omeprazole used in combination with amoxicillin and tinidazole appear equally effective in eradicating Helicobacter pylori infection, according to Taiwanese researchers.
Dr. Jyh-Jou Chen, of Chi Mei Foundation Hospital in Tainan, and colleagues note that in H. pylori treatment "the mechanism involved in the synergy between antibiotics and proton pump inhibitors is still controversial."
To investigate, the researchers studied two triple-therapy regimens differing only in the use of the antisecretory agent employed. They randomized 120 patients with peptic ulcer and non-ulcer dyspepsia to 2 weeks of treatment with twice-daily amoxicillin 1 g and twice-daily tinidazole 500 mg in combination with either famotidine 40 mg twice daily or omeprazole 20 mg twice daily.
There were no significant differences in response between groups, the team reports in the August issue of the European Journal of Gastroenterology and Hepatology. Overall, H. pylori eradication was achieved in 48 of the 60 patients in the famotidine group and 50 of the 60 patients in the omeprazole group. Excluding "dropouts and protocol violators," the corresponding figures were 48 of 53 in the famotidine group and 50 of 57 in the omeprazole group.
The researchers found that eradication rates did not differ significantly between metronidazole-resistant and metronidazole-susceptible strains of H. pylori. They say that acid suppression appears to be the "crucial mechanism" by which antibiotic activity is enhanced.