BOLOGNA, ITALY. Most cases of peptic (stomach and duodenal) ulcers are caused by an infection with the Helicobacter pylori bacterium. Helicobacter pylori infections have also been implicated in indigestion (dyspepsia), hives, inflammation of the stomach lining (gastritis), stomach cancer, and MALT lymphoma. These infections can usually be eradicated through a one- to two-week treatment with antibiotics and other drugs. Although the treatment is effective the need to take a dozen pills or more every day and endure the side effects of the treatment for a week or two has acted as a deterrent to the widespread use of the socalled triple therapy. Now researchers at the University of Bologna report favourable results with a new treatment protocol which is highly effective in eradicating Helicobacter pylori in just one weekend. The clinical trial involved 34 patients with duodenal ulcers and 37 patients with non-ulcer dyspepsia (indigestion). All patients had been found to harbour a tinidazole sensitive strain of Helicobacter pylori. They received 40 mg omeprazole (Losec) in the morning for seven days (Monday to Sunday). On Saturday and Sunday they also received 240 mg bismuth subcitrate (tablets) four times daily, 1000 mg amoxicillin (suspension) four times daily, and 500 mg tinidazole (tablets) four times daily. Endoscopy, urease testing, tissue evaluation (histology), and susceptibility studies were done before and 30 days after the treatment. The Helicobacter pylori infection was completely eradicated in 94 per cent of the patients with duodenal ulcers and in 74 per cent of the patients with dyspepsia. Treatment was found to be more effective during hot weather than during cold weather. Side effects were observed in 17 per cent of the patients, but did not require specific treatment. The patients consumed a high fat (33 per cent) diet during therapy to increase the contact time between the drugs and the stomach lining and were also encouraged to lie down in varying positions for 20 minutes after meals in order to facilitate the distribution of the drugs. The researchers conclude that weekend therapy with high doses of amoxicillin, tinidazole, and bismuth is an effective, safe, and inexpensive method for treating Helicobacter pylori infections.
Tucci, Antonio, et al. Weekend therapy for the treatment of Helicobacter pylori infection. American Journal of Gastroenterology, Vol. 93, May 1998, pp. 737- 42