Helicobacter pylori eradication reduces the rate of rebleeding in ulcer hemorrhage

To evaluate whether eradication with omeprazole and amoxicillin results in a reduction of ulcer recurrence and rebleeding in patients with Helicobacter pylori-associated duodenal ulcer hemorrhage, patients with upper gastrointestinal hemorrhage from duodenal ulcers with stigmata of recent hemorrhage, a drop in hemoglobin level of more than 2 g/dL, and documented H. pylori infection (by rapid urease test and histologic findings) were randomly assigned to receive omeprazole, 40 mg every day, and amoxicillin, 1 g twice a day, (Group A) or omeprazole alone, 40 mg every day, (Group B) for 2 weeks. No maintenance antiulcer therapy was given. Patients underwent a second endoscopy 4 weeks after completion of therapy and were followed for 1 year. Endoscopy was performed again at the end of 1 year. All patients showed ulcer healing 4 weeks after completion of therapy. H. pylori eradication rates were 83% (Group A) and 5% (Group B) ( p < .001). Ulcer recurrences were significantly lower in Group A (3/29 or 10%) than in Group B (9/22 or 41%; p < .05). Comparison of Group A patients with eradication and Group B patients without eradication also revealed a significant difference in rates of ulcer relapse (1/24 or 4% versus 9/21 or 43%; p