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One-week triple therapy with ranitidine bismuth citrate, clarithromycin and metronidazole versus two-week dual therapy with ranitidine bismuth citrate and clarithromycin for Helicobacter pylori infection: a randomized, clinical trial.
Am J Gastroenterol 1998; 93(8):1228-31AJ

Abstract

OBJECTIVE

The aim of this study was to compare the efficacy and side effects of 1-wk triple therapy with ranitidine bismuth citrate (RBC) 400 mg b.i.d., clarithromycin 500 mg b.i.d., and metronidazole 500 mg b.i.d., to 2-wk dual therapy with RBC 400 mg b.i.d. and clarithromycin 500 mg b.i.d. for H. pylori infection in a randomized, clinical trial.

METHODS

Patients (18-80 yr) with a culture proven H. pylori infection were randomized to one of these regimens. Side effects were scored on a semiquantitative scale. Endoscopy was performed > or = 4 wk after treatment. Antral biopsy samples were taken for hematoxylin-eosin stain (HE), rapid urease test, and culture and corpus samples for culture and HE. Two weeks after the endoscopy, a 13C-urea breath test was performed. Eradication failure was defined as detection of H. pylori by culture or by at least two other tests.

RESULTS

A total of 104 patients, 54 men, age 54+/-14 yr, (36 duodenal ulcer, 16 gastric ulcer, and 52 functional dyspepsia) were included. Gender, age, and diagnosis were comparable in both groups. Fourteen of 52 patients in both triple and dual therapy, respectively, had significant side effects, but all patients completed the course. Eradication results were 49 of 52 (94%; 95% CI: 84-99%) and 50 of 52 (96%; 95% CI: 87-100%) on intention to treat analysis and 44 of 46 (96%; 95% CI: 85-99%) and 48 of 49 (98%; 95% CI: 89-100%) on per protocol analysis for triple and dual therapy respectively.

CONCLUSION

Both regimens are very effective and well tolerated in the treatment of H. pylori infection. The triple regimen has the advantage of being shorter.

Authors+Show Affiliations

Department of Internal Medicine, Bethesda Hospital, Hoogeveen, The Netherlands.No affiliation info availableNo 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

9707042

Citation

van der Wouden, E J., et al. "One-week Triple Therapy With Ranitidine Bismuth Citrate, Clarithromycin and Metronidazole Versus Two-week Dual Therapy With Ranitidine Bismuth Citrate and Clarithromycin for Helicobacter Pylori Infection: a Randomized, Clinical Trial." The American Journal of Gastroenterology, vol. 93, no. 8, 1998, pp. 1228-31.
van der Wouden EJ, Thijs JC, van Zwet AA, et al. One-week triple therapy with ranitidine bismuth citrate, clarithromycin and metronidazole versus two-week dual therapy with ranitidine bismuth citrate and clarithromycin for Helicobacter pylori infection: a randomized, clinical trial. Am J Gastroenterol. 1998;93(8):1228-31.
van der Wouden, E. J., Thijs, J. C., van Zwet, A. A., Kooy, A., & Kleibeuker, J. H. (1998). One-week triple therapy with ranitidine bismuth citrate, clarithromycin and metronidazole versus two-week dual therapy with ranitidine bismuth citrate and clarithromycin for Helicobacter pylori infection: a randomized, clinical trial. The American Journal of Gastroenterology, 93(8), pp. 1228-31.
van der Wouden EJ, et al. One-week Triple Therapy With Ranitidine Bismuth Citrate, Clarithromycin and Metronidazole Versus Two-week Dual Therapy With Ranitidine Bismuth Citrate and Clarithromycin for Helicobacter Pylori Infection: a Randomized, Clinical Trial. Am J Gastroenterol. 1998;93(8):1228-31. PubMed PMID: 9707042.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - One-week triple therapy with ranitidine bismuth citrate, clarithromycin and metronidazole versus two-week dual therapy with ranitidine bismuth citrate and clarithromycin for Helicobacter pylori infection: a randomized, clinical trial. AU - van der Wouden,E J, AU - Thijs,J C, AU - van Zwet,A A, AU - Kooy,A, AU - Kleibeuker,J H, PY - 1998/8/26/pubmed PY - 1998/8/26/medline PY - 1998/8/26/entrez SP - 1228 EP - 31 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 93 IS - 8 N2 - OBJECTIVE: The aim of this study was to compare the efficacy and side effects of 1-wk triple therapy with ranitidine bismuth citrate (RBC) 400 mg b.i.d., clarithromycin 500 mg b.i.d., and metronidazole 500 mg b.i.d., to 2-wk dual therapy with RBC 400 mg b.i.d. and clarithromycin 500 mg b.i.d. for H. pylori infection in a randomized, clinical trial. METHODS: Patients (18-80 yr) with a culture proven H. pylori infection were randomized to one of these regimens. Side effects were scored on a semiquantitative scale. Endoscopy was performed > or = 4 wk after treatment. Antral biopsy samples were taken for hematoxylin-eosin stain (HE), rapid urease test, and culture and corpus samples for culture and HE. Two weeks after the endoscopy, a 13C-urea breath test was performed. Eradication failure was defined as detection of H. pylori by culture or by at least two other tests. RESULTS: A total of 104 patients, 54 men, age 54+/-14 yr, (36 duodenal ulcer, 16 gastric ulcer, and 52 functional dyspepsia) were included. Gender, age, and diagnosis were comparable in both groups. Fourteen of 52 patients in both triple and dual therapy, respectively, had significant side effects, but all patients completed the course. Eradication results were 49 of 52 (94%; 95% CI: 84-99%) and 50 of 52 (96%; 95% CI: 87-100%) on intention to treat analysis and 44 of 46 (96%; 95% CI: 85-99%) and 48 of 49 (98%; 95% CI: 89-100%) on per protocol analysis for triple and dual therapy respectively. CONCLUSION: Both regimens are very effective and well tolerated in the treatment of H. pylori infection. The triple regimen has the advantage of being shorter. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9707042/One_week_triple_therapy_with_ranitidine_bismuth_citrate_clarithromycin_and_metronidazole_versus_two_week_dual_therapy_with_ranitidine_bismuth_citrate_and_clarithromycin_for_Helicobacter_pylori_infection:_a_randomized_clinical_trial_ L2 - http://Insights.ovid.com/pubmed?pmid=9707042 DB - PRIME DP - Unbound Medicine ER -