Editor,—The paper by Misiewiczet al (Gut1997;41:735–9) is an important contribution which demonstrates the usefulness of lansoprazole and clarithromycin combined with either amoxycillin or metronidazole in the treatment ofHelicobacter pylori infection.

However, there are some questions which arise:

(1)  Only half the patients had duodenal ulcers. There is good evidence that the response rate to eradication therapy is inferior in other patients and it is hard to justify grouping ulcer and non-ulcer patients together in the study.

(2)  Why use lansoprazole 30 mg twice daily? Optimal acid reduction should be achievable with 30 mg …