Effectiveness of ranitidine bismuth citrate and proton pump inhibitor based triple therapies of Helicobacter pylori in Turkey

Helicobacter pylori infection is the main cause of gastritis, gastroduodenal ulcer disease, MALT lymphoma, and adenocarcinoma of the stomach. The reported prevalence of H. pylori in the adult population in Turkey is 67.6%-81.3%. A national meta-analysis showed that the average H. pylori eradication rate with proton pump inhibitor-based triple regimens in Turkey had decreased from 84% in 1997 to 55.3% in 2004, suggesting a need to evaluate alternative regimens. Materials and The study was a prospective, single-center trial with a parallel group design. After the selection procedure, consecutive out-patients were assigned to one of six study groups using random sampling numbers. All patients received amoxicillin 1,000 mg b.i.d. and clarithromycin 500 mg b.i.d. along with ranitidine bismuth citrate 400 mg b.i.d., or omeprazole 20 mg b.i.d., or lansoprazole 30 mg b.i.d., or rabeprazole 20 mg b.i.d., or pantoprazole 40 mg b.i.d., or esomeprazole 40 mg b.i.d. for 14 days. When we look at the eradication rates of the treatment groups, only two groups [ranitidine bismuth citrate and rabeprazole groups] had eradication rates greater than 80%, both at intention to treat and per protocol analyses. The other four groups [omeprazole, lansoprazole, pantoprazole, and esomeprazole groups] showed statistically significant lower eradication rates both at intention to treat [between 57.6 and 66.7%] and per protocol [between 60.3 and 72.1%] analyses when compared with ranitidine bismuth citrate and rabeprazole groups [p<.05]. Ranitidine bismuth citrate and/or rabeprazole based triple therapies must be preferred for the first-line treatment of H. pylori infection

Effectiveness of ranitidine bismuth citrate based triple therapy for treating Helicobacter pylori.

OBJECTIVE: To determine the efficacy, safety and tolerance of a one week regimen of RBC, clarithromycin, and amoxicillin for H. pylori eradication in Thai patients. MATERIAL AND METHOD: Patients who were undergoing endoscopy for dyspeptic symptoms. On the day of endoscopy, three biopsies were taken for H. pylori diagnosis. The patients who had the presence of H. pylori infection by positive from rapid urease test or histologic examination were invited to take part in an open, prospective study. Patients received a combination of RBC 400 mg, clarithromycin 500 mg, and amoxicillin 1 g twice daily for 7 days. Repeated endoscopy was performed to evaluate H. pylori eradication at least 1 month after the end of treatment. Clinical symptoms, side effects and compliance were assessed by interview during the study and at follow-up. RESULTS: Thirty nine patients with H. pylori infection were included. Male and female rates was 27:12 with a mean age of 42.8 +/- 11.4 years (range 21-68). There was a 89.74 per cent eradication rate by intent-to-treat and 94.59 per cent by per-protocol analysis. There were no serious adverse events during the study. Two patients (5.13%) stopped the medication because of side effects. Two patients had failure to eradication after complete treatment. Subjective improvement of the clinical symptoms was found in 92.3 per cent. CONCLUSION: One week's regimen of RBC, clarithromycin, and amoxicillin triple therapy resulted in a relatively high efficacy, safety and tolerance for H. pylori eradication in Thai patients.