PMID- 11422472
OWN - NLM
STAT- MEDLINE
DCOM- 20010809
LR  - 20191104
IS  - 1083-4389 (Print)
IS  - 1083-4389 (Linking)
VI  - 6
IP  - 2
DP  - 2001 Jun
TI  - High efficacy of ranitidine bismuth citrate, amoxicillin, clarithromycin and 
      metronidazole twice daily for only five days in Helicobacter pylori Eradication.
PG  - 157-62
AB  - AIM: The combination of a proton pump inhibitor (PPI) or 
      ranitidine-bismuth-citrate (Rbc) and two antibiotics for 7-10 days are, at 
      present, the preferred treatments in Helicobacter pylori eradication. However, 
      therapies for fewer than 7 days have been scarcely evaluated and it is unknown 
      whether the length of treatment can be shortened, without a lost of efficacy, if 
      three instead of two antibiotics are used. The aim of our study was to evaluate 
      the efficacy of Rbc plus three antibiotics for only 5 days in H. pylori 
      eradication. METHODS: We prospectively studied 80 patients (34% duodenal ulcer, 
      66% functional dyspepsia) infected by H. pylori. At endoscopy, biopsies were 
      obtained for histological study and rapid urease test, and a 13C-urea breath test 
      was carried out. Urea breath test was repeated 4 weeks after completing 
      eradication treatment with Rbc [400 mg twice a day (bid)], amoxicillin (1 g bid), 
      clarithromycin (500 mg bid) and metronidazole (500 mg bid). All drugs were 
      administered together after breakfast and dinner for 5 days only, and no 
      treatment was administered thereafter. Compliance with therapy was determined 
      from the interrogatory and the recovery of empty envelopes of medications. 
      RESULTS: In 79 out of the 80 patients, H. pylori eradication success or failure 
      was assessed after therapy (one patient was lost from follow-up). All but one of 
      these 79 patients took all the medications (one patient stopped treatment on the 
      day 3 due to nausea/vomiting). Per protocol eradication was achieved in 72/78 
      (92%; 95% CI, 84-96%) and in 72/80 (90%; 81-95%) by intention-to-treat. Therapy 
      was more effective in patients with duodenal ulcer than in those with functional 
      dyspepsia [100% (87-100%) vs. 85% (73-92%) by intention-to-treat; p <.05]. 
      Adverse effects were described in ten patients (12%), and included the perception 
      of a metallic taste (eight patients), nausea/vomiting (two patients, one of them 
      abandoned the treatment due to this), and diarrhea (two patients). CONCLUSION: 
      The combination of Rbc, amoxicillin, clarithromycin and metronidazole for only 5 
      days represents a promising therapy for H. pylori infection, due to its high 
      efficacy, simple posology, low cost and excellent tolerance.
FAU - Gisbert, J P
AU  - Gisbert JP
AD  - Department of Gastroenterology, University Hospital of La Princesa, Madrid, 
      Spain.
FAU - Marcos, S
AU  - Marcos S
FAU - Gisbert, J L
AU  - Gisbert JL
FAU - Pajares, J M
AU  - Pajares JM
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - England
TA  - Helicobacter
JT  - Helicobacter
JID - 9605411
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Anti-Ulcer Agents)
RN  - 140QMO216E (Metronidazole)
RN  - 7AJ51I17KG (ranitidine bismuth citrate)
RN  - 804826J2HU (Amoxicillin)
RN  - 884KT10YB7 (Ranitidine)
RN  - H1250JIK0A (Clarithromycin)
RN  - U015TT5I8H (Bismuth)
SB  - IM
CIN - Helicobacter. 2001 Jun;6(2):81-3. PMID: 11422461
MH  - Adult
MH  - Amoxicillin/administration & dosage/therapeutic use
MH  - Anti-Bacterial Agents/administration & dosage/*therapeutic use
MH  - Anti-Ulcer Agents/administration & dosage/*therapeutic use
MH  - Bismuth/administration & dosage/*therapeutic use
MH  - Clarithromycin/administration & dosage/therapeutic use
MH  - Drug Therapy, Combination
MH  - Female
MH  - Helicobacter Infections/*drug therapy
MH  - Helicobacter pylori/*drug effects
MH  - Humans
MH  - Male
MH  - Metronidazole/administration & dosage/therapeutic use
MH  - Middle Aged
MH  - Ranitidine/administration & dosage/analogs & derivatives/*therapeutic use
EDAT- 2001/06/26 10:00
MHDA- 2001/08/10 10:01
CRDT- 2001/06/26 10:00
PHST- 2001/06/26 10:00 [pubmed]
PHST- 2001/08/10 10:01 [medline]
PHST- 2001/06/26 10:00 [entrez]
AID - hel023 [pii]
AID - 10.1046/j.1523-5378.2001.00023.x [doi]
PST - ppublish
SO  - Helicobacter. 2001 Jun;6(2):157-62. doi: 10.1046/j.1523-5378.2001.00023.x.