Esomeprazole-based one-week triple therapy with clarithromycin and metronidazole is effective in eradicating Helicobacter pylori in the absence of antimicrobial resistance.

: This study aimed to investigate the effectiveness of a one-week triple therapy with esomeprazole, clarithromycin and metronidazole for eradication of Helicobacter pylori infection in the absence of antimicrobial resistance. : Patients testing positive for H. pylori susceptible to metronidazole and clarithromycin ( E-test) were randomized to receive a one-week regimen with either esomeprazole 2 × 20 mg or omeprazole 2 × 20 mg in combination with clarithromycin 2 × 250 mg and metronidazole 2 × 400 mg. Follow-up endoscopy with histology and culture and/or rapid urease test was performed 4–8 weeks after the end of treatment. : Eighty patients were randomized. Helicobacter pylori infection was cured in 38/39 patients of the esomeprazole group and 31/33 patients of the omeprazole group (per protocol 97.4% (95% confidence interval [CI], 86.2–99.9), 93.7% (95% CI, 79.2–99.2), P = 0.59); intention-to-treat 90.4% (95% CI: 77.4–97.3), 81.6% (95% CI: 65.7–92.3), respectively. No major side effects occurred. Minor side effects occurred in eight (20%) and six (23%) patients during esomeprazole and omeprazole therapy, respectively. Post-treatment susceptibility testing revealed resistance to both metronidazole and clarithromycin in two of the three patients who failed. : We conclude that esomeprazole, clarithromycin and metronidazole as one-week triple therapy is effective for eradication of H. pylori in the absence of antimicrobial resistance. [ABSTRACT FROM AUTHOR]