[Eradication of Helicobacter pylori in peptic ulcer and chronic gastritis. A randomized clinical trial].
BACKGROUND: The Helicobacter pylori (Hp) is found in patients with gastritis and peptic ulcer approximately in up to 80 percent. The eradication rates of 80 to 90 percent are achievable with some regimens. AIMS: Evaluate two regimens for H pylori eradication in gastritis and peptic ulcer. METHODS: Patients more than 20 years old with gastritis, gastric and duodenal ulcer disease and H pylori positive entered the study. We investigated prior history of peptic ulcer and hemorrhage, NSAID's use, smoking, alcoholism and epigastric pain. Endoscopy was performed before and at the end of the 8-12 weeks treatment, biopsies were taken from the antrum for Hp histological detection. Patients were randomly assigned to receive bismuth-metronidazole-tetracycline-ranitidine or bismuth-metronidazole-amoxicillin-ranitidine during two weeks. STATISTICAL ANALYSIS: chi square and multivariate analysis. RESULTS: One hundred and eighteen patients were included in this study, 52% male and 48% female with mean age of 47 +/- 16 years. History of peptic ulcer and bleeding was present in 79% and 62% respectively. NSAID's, and tobacco use among all patients was 49%, and 30%. Epigastric pain, melena and hematemesis was present in 90%, 47% and 24% respectively. H pylori eradication treatment was successful in 70% in both regimens (pNS). Was no related to age, tobacco and alcohol for Hp eradication (pNS), and NSAID's use was inversely related to Hp eradication (p < 0.05). Persistent peptic ulcer was seen in 23%. CONCLUSIONS: Eradication treatment was successful in 70% (p NS). Peptic ulcer refractory in 23% of patients and NSAID's use was inversely related to Hp eradication (p 0.05).