[Azithromycin in one week quadruple therapy for H, pylori eradication]

ABSTRACT

In developing countries primary antibiotic-resistance and poor compliance are the main causes of helicobacter pylori [HP] eradication failure of standard regimens. AIM: To investigate eradication rate, patient's compliance and tolerability of a 1-wk Azithromycin based quaruple therapy versus the 2-wk conventional therapy. A total of 129 HP-positive patients were randomized to either omeprazole 20mg, bismuth subcitrate 240 mg, azithromycin 250 mg, metronidazole 500 mg, all twice daily for 1- wk [BOAzM] or omeprazole 20mg, bismuth subcitrate 240 mg, amoxicillin 1g, metronidazole 500 mg all twice daily for 2-wk [B-OAM]. HP infection was defined at entry by histology and rapid urease test and cure of infection was determined by negative urea breath test. HP eradication rates of B-OAzM and B-OAM were74.1% and 70.4% respectively at intention to treat and per-protocol analysis 78.1%versus 75.7% respectively. incidence of poor compliance was lower, although not significant, in patients randomized to B-OAzM than for B-OAM [3.5% versus 4.3%] but intolerability was similar in two groups [35% versus 33.3%]. 1-wk azithromycin based quadruple regimen achieves an HP eradication rate comparable to that of standard 2-wk quadruple Therapy and is associated with same patient's compliance and complications