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GASTRIC ULCERS CURED WITH ANTIBIOTICS ALONE.
A recent study showed that the use of antibiotics without concomitant acid suppression is sufficient to heal H. pylori-positive duodenal ulcers (see Journal Watch accession number 940315001 and Lancet 1994; 343:508-10.) According to this new randomized trial, the same is true for gastric ulcers. Eighty-five patients with H. pylori-positive gastric ulcer (not related to nonsteroidal anti-inflammatory drugs) received either four weeks of omeprazole or a one-week course of bismuth subcitrate plus tetracycline and metronidazole. At nine weeks, 95 percent of both groups had complete healing of ulcers. About half the patients were followed for one year. Recurrent ulcers were found in 12 of 23 omeprazole-treated patients and only 1 of 22 antibiotic- treated patients. When compared with antibiotic therapy, the only advantage of using omeprazole was more rapid pain relief during the first week of treatment. Comment: Acid suppression appears to be unnecessary for promoting the healing of H. pylori-positive gastric ulcers; antibiotics alone are sufficient. This finding adds yet another link to the chain of evidence supporting a causal role for H. pylori in peptic ulcer.
— AS Brett
Published in Journal Watch General Medicine February 3, 1995
Citation(s):
Sung JJY, et al. Antibacterial treatment of gastric ulcers associated with Helicobacter pylori. N Engl J Med 1995 Jan 19 332 139-142.
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