Intravenous eradication therapy for bleeding gastroduodenal ulcer associated with Helicobacter pylori infection.

Abstract To evaluate the efficacy of an ultrashort intravenous triple therapy against Helicobacter pylori infection in patients with bleeding peptic ulcer. Thirty patients with bleeding peptic ulcer were studied prospectively. At endoscopy, two corpus and antrum biopsies were obtained for urease testing and culture. If H. pylori infection was found (positive urease test), the patient was treated with omeprazole 40 mg bid, metronidazole 500 mg tid and ampicillin 2000 mg fid for three days and then with ranitidine 150 mg bid for 2 months until eradication. In all patients a [13C]urea breath test was done at 2-month intervals, and in patients with gastric ulcer an endoscopy was also done and biopsies for culture and urease testing were obtained. Eradication efficacy (intention-to-treat) was 86.6% (26 out of 30). All schedules were administered in full and no patient had any adverse reactions. No patients had rebleeding. Ultrashort three-day triple therapy can achieve an eradication rate greater than 80%, with good acceptance and compliance, and without adverse events.