Ranitidine bismuth citrate-based triple therapy for seven days, with or without further anti-secretory therapy, is highly effective in patients with duodenal ulcer and Helicobacter pylori infection.

Abstract

OBJECTIVE:

To compare the efficacy of two protocols for the eradication of Helicobacter pylori infection and the healing of active duodenal ulcer: (i) ranitidine bismuth citrate (RBC) plus two antibiotics for 7 days, and (ii) the same triple therapy followed by 3 weeks of anti-secretory drug treatment.

METHODS:

The study comprised 102 patients with active duodenal ulcer and H. pylori infection; the patients were randomized to open treatment with either RBC 400 mg b.d. plus amoxycillin 1 g b.d. and clarithromycin 500 mg b.d. for 7 days, or the same treatment followed by 3 weeks of RBC 400 mg b.d. alone. Ulcer healing was confirmed by endoscopy. H. pylori eradication was assessed by endoscopy, rapid urease test and histology.

RESULTS:

The ulcer healed in 48/50 patients on RBC-based triple therapy alone (96.0%) and in 51/52 patients on triple therapy plus further anti-secretory treatment (98.1%). On an intention-to-treat basis, H. pylori had been successfully eradicated in 42/50 patients on triple therapy (84.0%) and in 44/52 patients on triple therapy plus anti-secretory treatment (84.6%), while by per protocol analysis the H. pylori eradication rates were 91.3% (42/46) and 89.8% (44/49), respectively.

CONCLUSIONS:

One-week triple therapy with RBC, amoxycillin and clarithromycin is highly effective in eradicating H. pylori and healing duodenal ulcers, even if not followed by anti-secretory drug treatment.

• Authors: S Marchi, F Costa, M Bellini, C Belcari, M G Mumolo, A Tornar, R Spisni, E Torelli, G Maltinti
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 13 Issue 5 Pg. 547-50 (May 2001) ISSN: 0954-691X [Print] England
• PMID: 11396535 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Antacids
• Anti-Bacterial Agents
• Anti-Ulcer Agents
• Histamine H2 Antagonists
• Organometallic Compounds
• Sucralfate
• Amoxicillin
• Ranitidine
• Clarithromycin
• bismuth tripotassium dicitrate

Topics

• Adult
• Aged
• Aged, 80 and over
• Amoxicillin (therapeutic use)
• Antacids (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Anti-Ulcer Agents (therapeutic use)
• Clarithromycin (therapeutic use)
• Clinical Protocols
• Drug Administration Schedule
• Drug Therapy, Combination
• Duodenal Ulcer (drug therapy, microbiology)
• Duodenoscopy
• Female
• Helicobacter Infections (drug therapy, microbiology)
• Helicobacter pylori (isolation & purification)
• Histamine H2 Antagonists (therapeutic use)
• Humans
• Male
• Middle Aged
• Organometallic Compounds (therapeutic use)
• Ranitidine (therapeutic use)
• Sucralfate (therapeutic use)
• Treatment Outcome