One week triple therapy for Helicobacter pylori: a multicentre comparative study. Lansoprazole Helicobacter Study Group

Gut. 1997 Dec;41(6):735-9. doi: 10.1136/gut.41.6.735.


Background: Eradication of Helicobacter pylori cures and prevents the relapse of duodenal ulceration and also results in histological resolution of chronic active gastritis.

Aim: To compare four treatment regimens lasting seven days of a proton pump inhibitor and two antibiotics in the eradication of H pylori.

Patients: Men or women with H pylori positive duodenal ulceration or gastritis, or both.

Methods: A single blind, prospectively randomised, parallel group, comparative, multicentre study. After a positive CLO test, patients underwent histology, H pylori culture, and a 13C urea breath test to confirm H pylori status. Treatment with one of four regimens: LAC, LAM, LCM, or OAM, where L is 30 mg of lansoprazole twice daily, A is 1 g of amoxycillin twice daily, M is 400 mg of metronidazole twice daily, C is 250 mg of clarithromycin twice daily, and O is 20 mg of omeprazole twice daily, was assigned randomly. A follow up breath test was done at least 28 days after completing treatment.

Results: H pylori eradication (intention to treat) was 104/121 (86.0%) with LAC, 87/131 (66.4%) with LAM, 103/118 (87.3%) with LCM, and 94/126 (74.6%) with OAM. There was a significant difference (p < 0.001) in the proportion of patients in whom eradication was successful between LAC and LCM when compared with LAM, but no significant difference (p = 0.15) between LAM and OAM. Metronidazole resistance before treatment was identified as a significant prognostic factor with regard to eradication of H pylori. The regimens which contained metronidazole were significantly less effective than those without metronidazole in the presence of pretreatment resistant H pylori. There was no difference among the treatment groups with regard to the incidence and severity of adverse events reported.

Conclusions: All four treatment regimens were safe and effective in eradicating H pylori in the patient population studied. LAC was the most efficacious treatment in patients with pretreatment metronidazole resistant H pylori, and was significantly better than LAM and OAM in this group of patients.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Adult
  • Aged
  • Aged, 80 and over
  • Amoxicillin / administration & dosage
  • Anti-Ulcer Agents / administration & dosage
  • Antitrichomonal Agents / administration & dosage
  • Clarithromycin / administration & dosage
  • Drug Resistance, Microbial
  • Drug Therapy, Combination / therapeutic use*
  • Duodenal Ulcer / drug therapy
  • Duodenal Ulcer / microbiology*
  • Female
  • Gastritis / drug therapy
  • Gastritis / microbiology*
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori*
  • Humans
  • Lansoprazole
  • Male
  • Metronidazole / administration & dosage
  • Middle Aged
  • Omeprazole / administration & dosage
  • Omeprazole / analogs & derivatives
  • Prospective Studies
  • Proton Pump Inhibitors
  • Single-Blind Method


  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Ulcer Agents
  • Antitrichomonal Agents
  • Proton Pump Inhibitors
  • Lansoprazole
  • Metronidazole
  • Amoxicillin
  • Clarithromycin
  • Omeprazole