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One‐week ranitidine bismuth citrate‐based triple therapy for the eradication of Helicobacter pylori in Hong Kong with high prevalence of metronidazole resistance
Author(s) -
Wong B. C. Y.,
Wong W. M.,
Wang W. H.,
Fung F. M. Y.,
Lai K. C.,
Chu K. M.,
Yuen S. T.,
Leung S. Y.,
Hu W. H. C.,
Yuen M. F.,
Lau G. K. K.,
Chan C. K.,
Lam S. K.
Publication year - 2001
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.1365-2036.2001.00932.x
Subject(s) - metronidazole , medicine , omeprazole , clarithromycin , helicobacter pylori , ranitidine , ranitidine hydrochloride , gastroenterology , regimen , urea breath test , breath test , antibiotics , microbiology and biotechnology , helicobacter pylori infection , biology
Aim: To compare 1‐week ranitidine bismuth citrate‐based (RBC) triple therapy vs. omeprazole‐based (O) triple therapy for the eradication of Helicobacter pylori infection in Hong Kong with high prevalence of metronidazole resistance. Methods: Patients with non‐ulcer dyspepsia and H. pylori infection were randomized to receive either: (i) RBCCM: ranitidine bismuth citrate (pylorid) 400 mg, clarithromycin 250 mg and metronidazole 400 mg; or (ii) OCM: omeprazole 20 mg, clarithromycin 250 mg and metronidazole 400 mg, each given twice daily for 1 week. Endoscopy (CLO test, histology and culture) and 13 C‐urea breath test were performed before randomization and 6 weeks after drug treatment. Results: A total of 180 patients were randomized. H. pylori eradication rates (intention‐to‐treat, n =180/per protocol, n =166) were 83%/92% for RBCCM and 66%/70% for OCM ( P =0.01, intention‐to‐treat and P =0.001, per protocol, respectively). RBCCM treatment was unaffected by metronidazole susceptibility and achieved a significantly higher eradication rate in metronidazole‐resistant cases (89%) than the OCM group (45%, P =0.0064). Conclusion: One‐week ranitidine bismuth citrate‐based triple therapy is significantly better than omeprazole‐based triple therapy for the eradication of H. pylori infection, especially in metronidazole‐resistant cases. It is an effective regimen for the eradication of H. pylori infection in regions with a high prevalence of metronidazole resistance.