Ranitidine bismuth citrate‐based triple therapies after failure of the standard ‘Maastricht triple therapy’: a promising alternative to the quadruple therapy? | Zendy

Perri F. | Zendy; Villani M. R. | Zendy; Quitadamo M. | Zendy; Annese V. | Zendy; Niro G. A. | Zendy; Andriulli A. | Zendy

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Ranitidine bismuth citrate‐based triple therapies after failure of the standard ‘Maastricht triple therapy’: a promising alternative to the quadruple therapy?

Author(s) -

Perri F.,

Villani M. R.,

Quitadamo M.,

Annese V.,

Niro G. A.,

Andriulli A.

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.1365-2036.2001.01002.x

Subject(s) - medicine , amoxicillin , gastroenterology , tinidazole , group b , ranitidine , randomized controlled trial , helicobacter pylori , pharmacology , antibiotics , metronidazole , microbiology and biotechnology , biology

Background: Triple therapy with proton pump inhibitor, clarythromycin, and amoxicillin has been proposed in Maastricht as the first‐line treatment of H. pylori infection. Aim: To determine whether ranitidine bismuth citrate (RBC) based regimens may be used as second‐line treatments after ‘Maastricht therapy’ failure. Methods: A total of 285 patients with H. pylori infection were given a 7‐day treatment with pantoprazole 40 mg b.d., clarythromycin 500 mg b.d., and amoxicillin 1 g b.d. Patients who were still infected were randomly given one of the following 14‐day treatments: RBC 400 mg b.d. plus amoxicillin 1 g b.d. and tinidazole 500 mg b.d. (RAT group), RBC 400 mg b.d. plus amoxicillin 1 g b.d. and clarythromycin 500 mg b.d. (RAC group), and RBC 400 mg b.d. plus clarythromycin 500 mg b.d. and tinidazole 500 mg b.d. (RCT group). Results: The ‘Maastricht therapy’ achieved an eradication rate of 59% (95% CI: 54–65) on intention‐to‐treat analysis. The RAT, RAC, and RCT regimens achieved eradication rates of 81% (95% CI: 67–94), 43% (95% CI: 26–60), and 62% (95% CI: 44–80), respectively, on intention‐to‐treat analysis. Patient compliance was optimal in RAT and RAC groups. Conclusion: RBC plus tinidazole and either amoxicillin or clarythromycin can be used as second‐line therapies after failure of the Maastricht triple therapy.

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