SUMMARYBackground : Peptic ulcer patients need to be treated with antimicrobials to cure Helicobacter pylori infection. Seven-day quadruple therapy is the regimen with the highest cure rates. An ultra-short quadruple therapy was evaluated prospectively. Methods : Forty-six consecutive H. pylori positive patients (33 had proven ulcer disease) were prescribed lansoprazole 30 mg b.d. on days 1-4, and on day 4 they received in addition tripotassium dicitrato bismuthate 120 mg, tetracycline 250 mg and metronidazole 250 mg at 09

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.

No abstract

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.

A 2-day 'weekend' quadruple therapy cures only 60% of patients and cannot be recommended, but these findings provide an insight into the mode of action of quadruple therapy.