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Randomized comparison of ranitidine bismuth citrate-based triple therapies for Helicobacter pylori.
Am J Gastroenterol 1997; 92(12):2213-5AJ

Abstract

OBJECTIVES

In an attempt to increase the efficacy and simplicity of FDA-approved regimens for Helicobacter pylori, we studied (1) addition of an inexpensive antibiotic (amoxicillin) to twice-daily ranitidine bismuth citrate (RBC)-clarithromycin dual therapy, and (2) substitution of RBC for bismuth subsalicylate + H2-receptor antagonist in bismuth-based triple therapy.

METHODS

Subjects with previously untreated Helicobacter pylori infection documented by 13C-urea breath test plus either endoscopic biopsy or serology were randomly assigned to a 2-wk course of (1) RBC 400 mg b.i.d., amoxicillin 1 g b.i.d., and clarithromycin 500 mg b.i.d. (RAC), or (2) RBC 400 mg b.i.d., metronidazole 250 mg t.i.d., and tetracycline 500 mg t.i.d. (RMT). Repeat breath test was performed 4 wk after the completion of therapy.

RESULTS

Intent-to-treat and per-protocol cure rates for RAC were 46 of 50 patients (92%) and 45 of 47 patients (96%); for RMT they were 40 of 50 patients (80%) and 37 of 42 patients (88%). Study drugs were stopped due to side effects in three patients (6%) taking RAC and six patients (12%) taking RMT.

CONCLUSIONS

Twice-daily RBC-based triple therapy with clarithromycin and amoxicillin produces Helicobacter pylori eradication rates over 90%, which is comparable to rates seen with proton pump inhibitor-based triple therapies. RBC also may be substituted for bismuth subsalicylate and an + H2-receptor antagonist in standard bismuth-based triple therapy.

Authors+Show Affiliations

University of Southern California School of Medicine, Los Angeles, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9399755

Citation

Laine, L, et al. "Randomized Comparison of Ranitidine Bismuth Citrate-based Triple Therapies for Helicobacter Pylori." The American Journal of Gastroenterology, vol. 92, no. 12, 1997, pp. 2213-5.
Laine L, Estrada R, Trujillo M, et al. Randomized comparison of ranitidine bismuth citrate-based triple therapies for Helicobacter pylori. Am J Gastroenterol. 1997;92(12):2213-5.
Laine, L., Estrada, R., Trujillo, M., & Emami, S. (1997). Randomized comparison of ranitidine bismuth citrate-based triple therapies for Helicobacter pylori. The American Journal of Gastroenterology, 92(12), pp. 2213-5.
Laine L, et al. Randomized Comparison of Ranitidine Bismuth Citrate-based Triple Therapies for Helicobacter Pylori. Am J Gastroenterol. 1997;92(12):2213-5. PubMed PMID: 9399755.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized comparison of ranitidine bismuth citrate-based triple therapies for Helicobacter pylori. AU - Laine,L, AU - Estrada,R, AU - Trujillo,M, AU - Emami,S, PY - 1997/12/17/pubmed PY - 1997/12/17/medline PY - 1997/12/17/entrez SP - 2213 EP - 5 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 92 IS - 12 N2 - OBJECTIVES: In an attempt to increase the efficacy and simplicity of FDA-approved regimens for Helicobacter pylori, we studied (1) addition of an inexpensive antibiotic (amoxicillin) to twice-daily ranitidine bismuth citrate (RBC)-clarithromycin dual therapy, and (2) substitution of RBC for bismuth subsalicylate + H2-receptor antagonist in bismuth-based triple therapy. METHODS: Subjects with previously untreated Helicobacter pylori infection documented by 13C-urea breath test plus either endoscopic biopsy or serology were randomly assigned to a 2-wk course of (1) RBC 400 mg b.i.d., amoxicillin 1 g b.i.d., and clarithromycin 500 mg b.i.d. (RAC), or (2) RBC 400 mg b.i.d., metronidazole 250 mg t.i.d., and tetracycline 500 mg t.i.d. (RMT). Repeat breath test was performed 4 wk after the completion of therapy. RESULTS: Intent-to-treat and per-protocol cure rates for RAC were 46 of 50 patients (92%) and 45 of 47 patients (96%); for RMT they were 40 of 50 patients (80%) and 37 of 42 patients (88%). Study drugs were stopped due to side effects in three patients (6%) taking RAC and six patients (12%) taking RMT. CONCLUSIONS: Twice-daily RBC-based triple therapy with clarithromycin and amoxicillin produces Helicobacter pylori eradication rates over 90%, which is comparable to rates seen with proton pump inhibitor-based triple therapies. RBC also may be substituted for bismuth subsalicylate and an + H2-receptor antagonist in standard bismuth-based triple therapy. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9399755/Randomized_comparison_of_ranitidine_bismuth_citrate_based_triple_therapies_for_Helicobacter_pylori_ L2 - https://medlineplus.gov/helicobacterpyloriinfections.html DB - PRIME DP - Unbound Medicine ER -