The results with lansoprazole-quadruple therapy are comparable to the historic control group treated with omeprazole-quadruple therapy. The cure rare is very high, and although mild to moderate side effects occurred in many patients, everybody finished the treatment regime.

INTRODUCTIONHelicobacter pylori infection of the gastric mucosa is causally related to peptic ulcer disease and cure of this infection has therefore become the treatment goal in ulcer patients. 1±5 Several guidelines suggest that patients with non-ulcer dyspepsia should also be treated for the infection and a serological based`test and treat' strategy for young dyspeptics is gaining popularity. 3,4 Even though the indications for treatment are expanding, no consensus exists as to the most optimal therapy. Physicians and drug companies tried to identify a single antibiotic to cure the infection. The hope of ®nding such a`golden' or`magic bullet', however, has diminished over the years and presently physicians have to choose from a wide range of 14-day dual and 7±10-day triple or quadruple therapies.2, 5±8 Physicians seem to prefer the simpler regimens.Fourteen day bismuth-based triple therapy is the oldest effective and most widely investigated anti-Helicobacter therapy.2, 5±9 Treatment duration can be shortened to 7 days if a proton pump inhibitor is added (quadruple therapy). 8±10 This regimen has produced one of the highest cure rates.11±21 Patients, however, have to take many pills per day and the regimen is perceived as complex. Fear of non-compliance has delayed its global acceptance. SUMMARY Background:Recently a new`all in one' single capsule with the three components of bismuth-based triple therapy became available in trials for treating Helicobacter pylori. Aim: To investigate the ef®cacy and tolerability of this new capsule when combined with lansoprazole. Methods: A total of 66 consecutive infected patients from a single centre received two single triple capsules four times daily and lansoprazole 30 mg b.d. for 7 days. Each capsule contained 60 mg of bismuth subcitrate, 125 mg of tetracycline and 125 mg of metronidazole. Endoscopy with biopsies for CLO-test, histology and culture from antrum and corpus was performed before and at least 5 weeks after treatment.

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We evaluated the performance of three enzyme-linked immunosorbent assays (ELISAs) in detecting serum immunoglobulin G (IgG) and IgA antibodies to Helicobacter pylori; two were new ones from Pyloriset (Pyloriset EIA-G update and Pyloriset EIA-A update; Orion Diagnostica, Espoo, Finland), and the third was the Malakit EIA-G (Biolab, Limal, Belgium). Serum samples from 154 dyspeptic patients were collected. As a reference method, multiple biopsy specimens from different anatomical areas of the stomach were obtained by endoscopy and were analyzed by culture and/or histology and direct urease testing. Accordingly, 126 patients (82%) were found to be H. pylori positive and 28 patients (18%) were found to be H. pylori negative. To validate serology as a predictor of H. pylori infection, sensitivity, specificity, positive and negative predictive values, and accuracy of the assays were calculated against the H. pylori status as determined by the reference method. The corresponding data for the different ELISAs were 100%, 79%, 95%, 100%, and 96% for the Pyloriset EIA-G update, 81%, 89%, 97%, 52%, and 82% for the Pyloriset EIA-A update, and 87%, 86%, 96%, 60%, and 87% for the Malakit EIA-G, respectively. We conclude that the Pyloriset EIA-G update is a reliable and accurate test and that because of its 100% sensitivity, conjunctional IgA testing is not necessary. Its 100% negative predictive value makes it a very useful screening test. For purposes of excluding infection with H. pylori, the performance of the Malakit EIA-G is moderate but can be improved by conjunctional IgA testing. The Pyloriset EIA-A update can be useful as such a conjunctional test.

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