Intravenous 3-day Helicobacter pylori eradication therapy is highly effective in patients with bleeding peptic ulcer

Abstract

To evaluate the efficacy of 3-day intravenous Helicobacter pylori eradication therapy in patients with bleeding peptic ulcer associated with H. pylori infection. We studied 53 patients admitted to hospital with bleeding of the upper gastrointestinal tract due to peptic ulcer and positive urease test over a 12-month period. After endoscopic diagnosis, intravenous pantoprazole (40 mg/12 hours), metronidazole (500 mg/8 hours) and amoxicillin-clavulanic acid (1,000 mg/200 mg/8 hours) was administered for 72 hours. The efficacy of eradication therapy was evaluated by 13C-urea breath test at least 2 months after the end of treatment. Fifty-one patients were included. Of these, 40 had duodenal ulcer and 11 had gastric ulcer. H. pylori eradication was achieved in 87.5% of those with duodenal ulcers and in 63.6% of those with gastric ulcers (p = 0.066). No adverse reactions or episodes of bleeding recurrence were found and none of the patients withdrew from treatment. The ultra-short course eradication therapy used in this study is highly effective. Its efficacy is similar to that of oral treatment and it avoids certain problems such as adverse effects and adherence to treatment.