Objective: To obtain epidemiological data concerning Helicobacter pylori (H.p.) infections and peptic ulcer in patients with upper abdominal pain in a routine non-hospital based health-insurance practice, as well as to test the efficacy of H.p. eradication, especially with a new shortterm treatment scheme in this setting.
Patients and methods: H.p. status and possible peptic ulceration (urease test, biopsies of gastric antrum and body) were determined in 1242 consecutive patients with upper abdominal pain examined gastroscopically. Patients who were H.p. positive and had a peptic ulcer or recurrent gastritis with erosions were given dual or triple medication (lansoprazole or pantoprazole with one or two antibiotics: amoxycillin, clarithromycin, azithromycin, tinidazole), under conditions of controlled compliance.
Results: The H.p. infection rate was 45.9% for the whole group (mean age: 49.9 years). An acute ulceration was found in 10.4% of the whole group, i.e. 20.1% of the 129 H.p. positive patients. 194 patients were given an eradication treatment. In 62 of them, put on a new 6-day eradication regimen (azithromycin, 1 x 500 mg daily; tinidazole, 1 x 2000 mg/d; and pantoprazole, 2 x 40 mg/d), an eradication rate of 93% (under protocol) or 92% (intention to treat) was achieved.
Interpretation: In routine non-hospital practice a 6-day modified triple-medication treatment with azithromycin, tinidazole and pantoprazole proved efficacious in eradicating H.p. infection. It not only caused few side effects and was cheap, but also achieved high patient compliance.