Two‐day ‘weekend’ lansoprazole‐quadruple therapy for Helicobacter pylori infection

BACKGROUND: The very high cure rate of 1-week quadruple therapy offers an opportunity to study a shorter treatment duration. This is needed to construct a time-response curve for the regimen. METHODS: Fifty-two patients with endoscopically proven H. pylori infection received lansoprazole 30 mg b.d., tripotassium dicitrato bismuthate 120 mg q.d.s., tetracycline 500 mg q.d.s. and metronidazole 500 mg q.d.s., following 3 days of lansoprazole pre-treatment. A second endoscopy was performed at least 6 weeks later. A patient was cured if histology, CLO-test, and culture of antrum and corpus were negative. RESULTS: We achieved an intention-to-treat cure rate of 30/50 (60%, 95%, CI: 46-73%) and a per protocol cure rate of 30/48 (63%, 95% CI: 48-75%). Cure rate in metronidazole-sensitive strains was 24/37 (65%, 95% CI: 48-79%) and 2/5 (40%) in resistant strains. All patients that failed the regimen had a metronidazole-resistant strain post-treatment. Compliance was excellent and moderate or severe side-effects occurred in only 4% of patients. CONCLUSION: 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.