Esomeprazole versus omeprazole for the eradication of Helicobacter pylori infection: results of a randomized controlled study

J Clin Gastroenterol. 2004 Jul;38(6):503-6. doi: 10.1097/01.mcg.0000129061.54277.c6.


Background: Esomeprazole has higher oral bioavailability and increased antimicrobial activity against Helicobacter pylori than omeprazole.

Goals: To compare 7 days esomeprazole with 7 days of omeprazole based triple therapies for the eradication of H. pylori, and to assess whether the administration of higher dose of esomeprazole leads to improved eradication rates.

Study: One hundred and fifty-six dyspeptic patients with H. pylori received either: (1) 1-week treatment including esomeprazole 40 mg once daily, amoxicillin 1 g, and clarithromycin 500 mg, both twice daily (EAC1 group, n = 52); (2) 1-week treatment of omeprazole 20 mg, amoxicillin 1 g, and clarithromycin 500 mg, all administered twice daily (OAC group, n = 52); or (3) 1-week treatment with esomeprazole 40 mg, amoxicillin 1 g, and clarithromycin 500 mg, all given twice daily (EAC2 group, n = 52).

Results: H. pylori was eradicated in 37 of 52 patients in the OAC group (Intension to treat [ITT] 71%), and in 42 patients in the EAC1 group (ITT 81%). High eradication rate was achieved by the EAC2 regimen (ITT; 96%), but more patients reported unwanted effects.

Conclusion: Seven days of esomeprazole based triple therapy is a satisfactory eradication regimen for H. pylori infection. Higher doses of esomeprazole have excellent eradication rates, but they may lead to increased side effects.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Esomeprazole
  • Female
  • Follow-Up Studies
  • Gastritis / drug therapy*
  • Gastritis / microbiology
  • Helicobacter Infections / diagnosis
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori / drug effects*
  • Helicobacter pylori / isolation & purification
  • Humans
  • Male
  • Omeprazole / administration & dosage*
  • Pilot Projects
  • Probability
  • Prospective Studies
  • Reference Values
  • Treatment Outcome


  • Omeprazole
  • Esomeprazole