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Lansoprazole and secnidazole with clarithromycin, amoxycillin or pefloxacin in the eradication of Helicobacter pylori in a developing country
Author(s) -
Vineet Ahuja,
Anita Dhar,
Chandrasekhar Bal,
Manish R. Sharma
Publication year - 1998
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1998.00338.x
Subject(s) - lansoprazole , clarithromycin , helicobacter pylori , medicine , pefloxacin , gastroenterology , proton pump inhibitor , rapid urease test , breath test , amoxicillin , antibiotics , metronidazole , antibacterial agent , gastritis , microbiology and biotechnology , ofloxacin , ciprofloxacin , biology
Background: A number of triple drug regimens using proton pump inhibitors and two antibiotics have been evaluated in the West and reported to achieve Helicobacter pylori eradication rates of over 90%. In developing countries however, these combinations have neither been well evaluated, nor the optimum treatment for H. pylori infection well defined. Aim: To compare the combination of a proton pump inhibitor with a nitroimidazole and another antibiotic in eradicating H. pylori infection and healing duodenal ulcer. Methods: Sixty consecutive patients with active duodenal ulcer who were positive for H. pylori (by rapid urease test and 14 C‐urea breath test) were randomized into three treatments groups: (1) LAS ( n = 21): lansoprazole 30 mg o.m., amoxycillin 500 mg q.d.s. and secnidazole 2 g on alternate days for 2 weeks; (2) LCS ( n = 18): lansoprazole 30 mg o.m., clarithromycin 500 mg b.d. and secnidazole 2 g on alternate days for 1 week; (3) LPS ( n = 21): lansoprazole 30 mg o.m., pefloxacin 400 mg o.m. and secnidazole 2 g on alternate days for 2 weeks. Urease and breath tests were performed at 0, 6 and 12 weeks to check for H. pylori eradication. Results: Intention‐to‐treat eradication rates were as follows: LAS 86%, LCS 83%, LPS 71%; the overall ulcer healing rate was 90% at 6 weeks. Conclusions: High H. pylori eradication rates were achieved using the amoxycillin‐ and clarithromycin‐based therapies. Fewer side‐effects, better compliance and low cost favoured the amoxycillin‐based therapy.