{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T03:12:24Z","timestamp":1768878744987,"version":"3.49.0"},"reference-count":28,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1995,10]]},"abstract":"<jats:p>Triple therapy has been recommended as the most effective treatment for Helicobacter pylori eradication. Despite achieving a comparatively high eradication result, however, around 10% of patients still fail to be cured. Omeprazole can enhance efficacy of single and double antibiotic protocols and is particularly effective when combined with clarithromycin and a nitroimidazole. This study examined the effect of combining triple therapy with omeprazole. A prospective, randomised, unblinded, single centre trial was carried out on consecutive patients with symptoms of dyspepsia and H pylori infection confirmed by rapid urease test, microbiological culture, and histological assessment. Patients were given a five times\/day, 12 day course of colloidal bismuth subcitrate chewable tablets (108 mg), tetracycline HCl (250 mg), and metronidazole (200 mg) with either 20 mg omeprazole twice daily (triple therapy+omeprazole) or 40 mg famotidine (triple therapy+famotidine) at night. Compliance and side effects were determined using a standard questionnaire form. One hundred and twenty five of 165 triple therapy+omeprazole patients and 124 of 171 triple therapy+famotidine patients returned for rebiopsy four weeks after completion of treatment. Significantly more triple therapy+omeprazole patients achieved eradication 122 of 125 (97.6%) as assessed by negative urease test, culture, and histological assessment, when compared with 110 of 124 (89%) triple therapy+famotidine patients (p = 0.006; chi 2). There were 30 triple therapy+omeprazole (24%) and 26 triple therapy+famotidine (21%) patients with de novo metronidazole resistant H pylori included in the study. Side effects were mild and infrequent and were comparable in both groups, although pain in duodenal ulcer, gastric ulcer, and oesophagitis patients seemed to subside earlier in those taking omeprazole. Compliance (&gt;95% of drugs taken) was achieved by 98% of patients of both groups. A 12 days regimen of triple therapy with omeprazole is more effective in achieving H pylori eradication than is triple therapy plus famotidine. Use of 20 mg omeprazole twice daily rather than 40 mg famotidine with a 12 day, low dose triple therapy enhances eradication to over 97% whether the H pylori is metronidazole sensitive or resistant.<\/jats:p>","DOI":"10.1136\/gut.37.4.477","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"477-481","source":"Crossref","is-referenced-by-count":74,"title":["Omeprazole enhances efficacy of triple therapy in eradicating Helicobacter pylori."],"prefix":"10.1136","volume":"37","author":[{"given":"T J","family":"Borody","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Andrews","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Fracchia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Brandl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N P","family":"Shortis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Bae","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1995,10,1]]},"reference":[{"key":"ref_1","first-page":"1716","article-title":"Meta-analysis of the efficacy of antibiotic therapy in eradicating Helicobacter pylori","volume":"87","author":"Chiba, N.; Rao, B.V.; Rademaker, J.W.; Hunt, R.H.","year":"1992","unstructured":"Chiba N, Rao BV, Rademaker JW, Hunt RH. Meta-analysis of the efficacy of antibiotic therapy in eradicating Helicobacter pylori. AmJ7 Gastroenterol 1992; 87: 1716-27."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/j.1440-1746.1991.tb01452.x","article-title":"Helicobacter pylori therapy: effect on peptic ulcer disease","volume":"6","author":"Axon, A.T.R.","year":"1991","unstructured":"Axon ATR. Helicobacter pylori therapy: effect on peptic ulcer disease. Jf Gastroenterol Hepatol 1991; 6: 131-7.","journal-title":"Jf Gastroenterol Hepatol"},{"issue":"2","key":"ref_3","first-page":"92","article-title":"Reasons for failure of Helicobacter pylori treatment","volume":"5","author":"Ruaws, E.A.J.","year":"1993","unstructured":"Ruaws EAJ. Reasons for failure of Helicobacter pylori treatment. European Journal of Gastroenterology and Hepatology 1993; 5 (suppl 2): S92-5.","journal-title":"European Journal of Gastroenterology and Hepatology"},{"key":"ref_4","first-page":"43","article-title":"H pyloni eradication failure (EF) - further treatment possibilities","volume":"102","author":"Borody, T.J.; Brandl, S.; Andrews, P.; Jankiewicz, E.; Ostapowicz, N.","year":"1992","unstructured":"Borody TJ, Brandl S, Andrews P, Jankiewicz E, Ostapowicz N. H pyloni eradication failure (EF) - further treatment possibilities. Gastroenrerologry 1992; 102: A43.","journal-title":"Gastroenrerologry"},{"key":"ref_5","first-page":"313","article-title":"Short report: high-dose omeprazole and amoxycillin in the treatment of Helicobacter pylori-associated duodenal ulcer","volume":"7","author":"Collins, R.; Beattie, S.; Xis, H.X.; O'Morain, C.","year":"1993","unstructured":"Collins R, Beattie S, Xis HX, O'Morain C. Short report: high-dose omeprazole and amoxycillin in the treatment of Helicobacter pylori-associated duodenal ulcer. Aliment Pharmacol Ther 1993; 7: 313-5.","journal-title":"Aliment Pharmacol Ther"},{"key":"ref_6","first-page":"1502","article-title":"Failure of omeprazole to enhance antimicrobial therapy for H pyloni: omeprazole with tetracycline or tetracycline and bismuth","volume":"88","author":"Al-Assi, M.T.; Genta, R.M.; Graham, D.Y.","year":"1993","unstructured":"Al-Assi MT, Genta RM, Graham DY. Failure of omeprazole to enhance antimicrobial therapy for H pyloni: omeprazole with tetracycline or tetracycline and bismuth. AinJ Gastroenterol 1993; 88: 1502.","journal-title":"AinJ Gastroenterol"},{"key":"ref_7","first-page":"463","article-title":"Short report: treatment of Helicobacter pylori-associated duodenal ulcer with omeprazole plus antibiotics","volume":"7","author":"McCarthy, C.J.; Collins, R.; Beattie, S.; Hamilton, H.; O'Morain, C.","year":"1993","unstructured":"McCarthy CJ, Collins R, Beattie S, Hamilton H, O'Morain C. Short report: treatment of Helicobacter pylori-associated duodenal ulcer with omeprazole plus antibiotics. Aliment Pharmacol Ther 1993; 7: 463-6.","journal-title":"Aliment Pharmacol Ther"},{"issue":"1","key":"ref_8","first-page":"37","article-title":"Helicobacter pylori eradication: a combination of omeprazole, amoxycillin and metronidazole compared with standard triple therapy","volume":"34","author":"Bell, G.D.; Powell, K.U.; Burridge, S.M.; Rameh, B.; Bolton, G.; Purser, K.","year":"1993","unstructured":"Bell GD, Powell KU, Burridge SM, Rameh B, Bolton G, Purser K, et al. Helicobacter pylori eradication: a combination of omeprazole, amoxycillin and metronidazole compared with standard triple therapy. Gut 1993; 34 (suppl 1): S37.","journal-title":"Gut"},{"issue":"2","key":"ref_9","first-page":"37","article-title":"Possibilities for Helicobacter pylori suppression\/eradication","volume-title":"European Journal of Gastroenterology and Hepatology 1992","volume":"4","author":"Borody, T.J.","unstructured":"Borody TJ. Possibilities for Helicobacter pylori suppression\/eradication. European Journal of Gastroenterology and Hepatology 1992; 4 (suppl 2): S37-40."},{"key":"ref_10","first-page":"529","article-title":"Helicobacter pylori reinfection rate, in patients with cured duodenal ulcer","volume":"89","author":"Borody, T.J.; Andrews, P.; Mancuso, N.; Macauley, D.; Jankiewicz, E.; Ferch, N.","year":"1994","unstructured":"Borody TJ, Andrews P, Mancuso N, Macauley D, Jankiewicz E, Ferch N, et al. Helicobacter pylori reinfection rate, in patients with cured duodenal ulcer. Am J Gastroenterol 1994; 89: 529-32.","journal-title":"Am J Gastroenterol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"\"508","DOI":"10.1016\/S0140-6736(94)91460-5","article-title":"Duodenal ulcer healing by eradication of Helicobacter pylori without anti-acid treatment: randomised controlled trial","volume":"343","author":"Hosking, S.W.; Ling, T.K.W.; Chung, S.C.S.; Yung, M.Y.; Cheng, A.F.B.; Sung, J.J.S.","year":"1994","unstructured":"Hosking SW, Ling TKW, Chung SCS, Yung MY, Cheng AFB, Sung JJS, et al. Duodenal ulcer healing by eradication of Helicobacter pylori without anti-acid treatment: randomised controlled trial. Lancet 1994; 343: 508-10. 1994; 35 (suppl 2): S62.","journal-title":"Lancet"},{"key":"ref_12","first-page":"40","article-title":"Efficacy and tolerability of short term low-dose triple therapy for eradication","volume-title":"of Helicobacter pylori. Gastroenterology 1993; 104","author":"Bazzoli, F.; Zagary, R.M.; Fossi, S.; Pozzato, P.; Roda, A.; Roda, E.","unstructured":"Bazzoli F, Zagary RM, Fossi S, Pozzato P, Roda A, Roda E. Efficacy and tolerability of short term low-dose triple therapy for eradication of Helicobacter pylori. Gastroenterology 1993; 104: A40."},{"key":"ref_13","first-page":"502","article-title":"Randomised controlled trial of short term treatment to eradicate Helicobacter pylori in patients with duodenal ulcer","volume":"305","author":"Hosking, S.W.; Ling, T.K.W.; Yung, M.Y.; Cheng, A.; Chung, S.C.S.; Leung, J.W.C.","year":"1992","unstructured":"Hosking SW, Ling TKW, Yung MY, Cheng A, Chung SCS, Leung JWC, et al. Randomised controlled trial of short term treatment to eradicate Helicobacter pylori in patients with duodenal ulcer. BMJ3 1992; 305: 502-4."},{"key":"ref_14","article-title":"Optimising therapy for. H pylori gastritis","author":"Daskalopoulos, G.; Carrick, J.; Lian, R.; Lee, A.","year":"1992","unstructured":"Daskalopoulos G, Carrick J, Lian R, Lee A. Optimising therapy for.H pylori gastritis. Ir J Med Sci 1992; 166","journal-title":"Ir J Med Sci"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1007\/BF01303176","article-title":"One-day therapy for treatment of Helicobacter pylori infection","volume":"38","author":"Tucci, A.; Corinaldesi, R.; Stanghellini, V.; Paparo, G.F.; Gasperoni, S.; Biasco, G.","year":"1993","unstructured":"Tucci A, Corinaldesi R, Stanghellini V, Paparo GF, Gasperoni S, Biasco G, et al. One-day therapy for treatment of Helicobacter pylori infection. Dig Dis Sci 1993; 38: 1670-3.","journal-title":"Dig Dis Sci"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1136\/gut.34.9.1167","article-title":"Amoxycillin plus omeprazole versus triple therapy for eradication of Helicobacter pylori in duodenal ulcer disease: a prospective, randomised, and controlled study","volume":"34","author":"Labenz, J.; Gyenes, E.; Ruhl, G.H.; Borsch, G.","year":"1993","unstructured":"Labenz J, Gyenes E, Ruhl GH, Borsch G. Amoxycillin plus omeprazole versus triple therapy for eradication of Helicobacter pylori in duodenal ulcer disease: a prospective, randomised, and controlled study. Gut 1993; 34: 1167-70.","journal-title":"Gut"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/0016-5085(92)91135-Q","article-title":"Helicobacter pylori and non-ulcer dyspepsia","volume":"103","author":"O'Morain, C.","year":"1992","unstructured":"O'Morain C. Helicobacter pylori and non-ulcer dyspepsia. Gastroenterology 1992; 103: 340-7.","journal-title":"Gastroenterology"},{"key":"ref_18","first-page":"86","article-title":"The Declaration of Helsinki","volume":"29","author":"Assembly, World Medical","year":"1982","unstructured":"World Medical Assembly. The Declaration of Helsinki. World Med J 1982; 29: 86-8.","journal-title":"World Med J"},{"key":"ref_19","first-page":"1154","article-title":"Helicobacter pylori-negative duodenal ulcer","volume":"89","author":"Borody, T.J.; George, L.L.; Brandl, S.; Andrews, P.; Ostapowicz, N.; Hyland, L.","year":"1991","unstructured":"Borody TJ, George LL, Brandl S, Andrews P, Ostapowicz N, Hyland L, et al. Helicobacter pylori-negative duodenal ulcer. Am J Gastroenterol 1991; 89: 1154-7.","journal-title":"Am J Gastroenterol"},{"key":"ref_20","first-page":"817","article-title":"Endoscopic diagnosis of Helicobacter pylori (H pylori) - approaching the 'Gold Standard'. Abstracts ofthe World Congresses of Gastroenterology","volume":"4","author":"Borody, T.J.; Andrews, P.J.; Brandl, S.; Hyland, L.; Morgan, A.; Ostapowicz, N.","year":"1992","unstructured":"Borody TJ, Andrews PJ, Brandl S, Hyland L, Morgan A, Ostapowicz N, et al. Endoscopic diagnosis of Helicobacter pylori (H pylori) - approaching the 'Gold Standard'. Abstracts ofthe World Congresses of Gastroenterology, Sydney, 1990. Abingdon: The Medicine Group (UK) Ltd, 1990: EurJ Gastroenterol Hepatol 1992; 4: 817-23."},{"issue":"1","key":"ref_21","first-page":"7","article-title":"Helicobacter pylori. EurJ Gastroenterol Hepatol","volume":"4","author":"Tytgat, G.N.J.; Noach, L.A.; Rauws, E.A.J.","year":"1992","unstructured":"Tytgat GNJ, Noach LA, Rauws EAJ. Helicobacter pylori. EurJ Gastroenterol Hepatol 1992; 4 (suppl 1): S7-15."},{"key":"ref_22","first-page":"327","article-title":"Does a previous course of tripotassium dicitrato bismuthate affect the subsequent changes of successful Helicobacter pylori eradication?","volume":"6","author":"Bell, G.D.; Powell, K.; Burridge, S.M.; Harrison, G.; Weil, J.; Gant, P.W.","year":"1992","unstructured":"Bell GD, Powell K, Burridge SM, Harrison G, Weil J, Gant PW, et al. Does a previous course of tripotassium dicitrato bismuthate affect the subsequent changes of successful Helicobacter pylori eradication? Aliment Pharmacol Ther 1992; 6: 327-33.","journal-title":"Aliment Pharmacol Ther"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/00042737-199303000-00004","article-title":"Clinical efficacy of triple therapy in Helicobacter pylori-associated duodenal ulcer","volume":"5","author":"Xia, H.; Daw, M.A.; Sant, S.; Beattie, S.; Keane, C.T.; O'Morain, C.A.","year":"1993","unstructured":"Xia H, Daw MA, Sant S, Beattie S, Keane CT, O'Morain CA. Clinical efficacy of triple therapy in Helicobacter pylori-associated duodenal ulcer. Eur J Gastroenterol Hepatol 1993; 5: 141-4.","journal-title":"Eur J Gastroenterol Hepatol"},{"issue":"18","key":"ref_24","first-page":"1315","article-title":"Campylobacter pylori gastritis. I: Detection of urease as a marker of bacterial colonisation and gastritis","volume":"91","author":"Marshall, B.J.; Guerrant, R.L.; Hoffman, SR, Barrett; R.W.","year":"1987","unstructured":"Marshall BJ, Guerrant RL, Hoffman SR, Barrett RW, PD91. 18 Hazell SL, Borody TJ, Gal A, Lee A. Campylobacter pylori gastritis. I: Detection of urease as a marker of bacterial colonisation and gastritis. Am J Gastroenterol 1987; 82: McCallum RW. Eradication of metronidazole resistant H pylori [Abstract]. Am Gastroenterol 1991; 86: 1315.","journal-title":"Am J Gastroenterol; 82: McCallum RW. Eradication of metronidazole resistant H pylori"},{"key":"ref_25","first-page":"66","article-title":"Quadruple therapy eradicates nitroimidazole resistant H 292-6","volume":"56","author":"Seppala, K.; Sipponen, P.; Farkkila, M.; Kosunen, T.U.","year":"1993","unstructured":"Seppala K, Sipponen P, Farkkila M, Kosunen TU. Quadruple therapy eradicates nitroimidazole resistant H 292-6. 19 Borody T, Andrews P, Brandl S, Devine M. Relevance of in-vitro metronidazole resistance to H pylori (HP) eradication and eradication failure. Gastroenterology 1993; 104: pylori. Acta Gastroenterolog Belg 1993; 56: 66.","journal-title":"Relevance of in-vitro metronidazole resistance to H pylori (HP) eradication and eradication failure. Gastroenterology 1993; 104: pylori; Acta Gastroenterolog Belg"},{"key":"ref_26","first-page":"33","article-title":"Use of high efficacy, lower dose triple therapy to reduce side effects of eradicating Helicobacter pylori","volume":"89","author":"Borody, T.J.; Brandl, S.; Andrews, P.; Ferch, N.; Jankiewicz, E.; Hyland, L.","year":"1994","unstructured":"Borody TJ, Brandl S, Andrews P, Ferch N, Jankiewicz E, Hyland L. Use of high efficacy, lower dose triple therapy to reduce side effects of eradicating Helicobacter pylori. Am Y Gastroenterol 1994; 89: 33-8.","journal-title":"Am Y Gastroenterol"},{"issue":"10","key":"ref_27","first-page":"12","article-title":"Omeprazole plus amoxycillin: efficacy of various treatment regimens to eradicate Helicobacter pylori","volume":"161","author":"Labenz, J.; Gyenes, E.; Ruhl, G.H.; Borsch, G.","year":"1993","unstructured":"Labenz J, Gyenes E, Ruhl GH, Borsch G. Omeprazole plus amoxycillin: efficacy of various treatment regimens to eradicate Helicobacter pylori. Am J Gastroenterol 1993; Med Sci 1992; 161 (suppl 10): 12.","journal-title":"Am J Gastroenterol"},{"key":"ref_28","series-title":"Interfalk Conference Proceedings: Ritz-Carlton Hotel, Amelia IS FL","first-page":"\"3","article-title":"The silent minority - eradication of Helicobacter pylori infection where standard triple therapy has failed. H pylori. Basic mechanisms to clinical cure","author":"36.","year":"1993","unstructured":"Daskalopoulos G, Carrick J, [ian RX, Lee A. The silent minority - eradication of Helicobacter pylori infection where standard triple therapy has failed. H pylori. Basic mechanisms to clinical cure. Interfalk Conference Proceedings: Ritz-Carlton Hotel, Amelia IS FL; Nov 3-6, 1993: 36."}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.37.4.477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T03:05:10Z","timestamp":1764990310000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.37.4.477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,10]]},"references-count":28,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1995,10,1]]},"published-print":{"date-parts":[[1995,10]]}},"alternative-id":["10.1136\/gut.37.4.477"],"URL":"https:\/\/doi.org\/10.1136\/gut.37.4.477","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,10]]}}}