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Helicobacter pylori ‐positive duodenal ulcer: three‐day antibiotic eradication regimen
Author(s) -
Catalano F.,
Branciforte G.,
Catanzaro R.,
Cipolla R.,
Bentivegna C.,
Brogna A.
Publication year - 2000
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.1365-2036.2000.00839.x
Subject(s) - omeprazole , clarithromycin , medicine , regimen , metronidazole , gastroenterology , helicobacter pylori , proton pump inhibitor , ranitidine , ranitidine hydrochloride , amoxicillin , antibiotics , microbiology and biotechnology , biology
Background: The most widely used treatments for ulcer healing and Helicobacter pylori eradication consist of a 1–2 week regimen of a proton pump inhibitor plus two or three antimicrobials. Aims: To evaluate the efficacy, safety, cost, and tolerance of a three‐day regimen with three antibiotics vs. a 10‐day treatment with a proton pump inhibitor or vs. a ranitidine bismuth citrate triple therapy. Methods: Two hundred and twenty‐one patients with endoscopically‐proven H. pylori ‐positive duodenal ulcers were recruited to the study. Recruited patients were assigned to one of the following four regimens: (I) omeprazole 40 mg o.m. plus amoxycillin 1 g b.d. and clarithromycin 500 mg b.d. for 10 days (OAC: 55 patients); (ii) omeprazole 40 mg o.m. on days 1–5, plus amoxycillin 1 g b.d., clarithromycin 500 mg b.d. and metronidazole 500 mg b.d. on days 3–5 (OACM: 56 patients); (iii) ranitidine bismuth citrate 400 mg b.d. plus amoxycillin 1 g b.d. and clarithromycin 500 mg b.d. for 10 days (RAC: 54 patients); (iv) ranitidine bismuth citrate 400 mg b.d. on days 1–5, plus amoxycillin 1 g b.d., clarithromycin 500 mg b.d. and metronidazole 500 mg b.d. on days 3–5 (RACM: 56 patients). Fisher’s exact test was used to compare data regarding healing and eradication in the four groups. Results: The intention‐to‐treat eradication and ulcer healing rates for the RACM regimen were 95% and 98%, respectively. Statistically significant differences were observed, relating to the eradication and healing of ulcers, between RACM and either the RAC or OAC regimens. Conclusion: The three‐day antibiotic therapy with amoxycillin, clarithromycin and metronidazole in addition to ranitidine bismuth citrate is a very effective anti‐ H. pylori regimen.