Mohsen Amini1, Hossein Khedmat, Fatemeh Yari. 1. Internal Medicine Department, Gastrointestinal Endoscopy Division, Baqiyatallah Medical Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND: The eradication of Helicobacter pylori (HP) is dependent on several bacteriologic and geographic variables. Multiple-drug regimens have been tried in order to eradicate HPi; however, the optimal drug has not yet been found. MATERIAL/ METHODS: In this single-blind, randomized clinical trial, 245 dyspeptic patients with positive rapid urease tests or positive cultures for HP were entered in the study and randomly treated with one of 3 drug regimens A, B, or C for 14 days. Each regimen was administered to 76 patients. Regimen A consisted of omeprazole 20 mg bid + bismuth subcitrate 120 mg 2 tab. bid + metronidazole 250 mg 2 tab. bid + tetracycline 250 mg 2 cap. bid. Regimen B consisted of omeprazole 20 mg bid + bismuth subcitrate 120 mg 2 tab. bid + furazolidone 100 mg 2 tab. bid + tetracycline 250 mg 2 cap. bid. Regimen C consisted of omeprazole 20 mg bid + bismuth subcitrate 120 mg 2 tab. bid + ciprofloxacin 500 mg bid. A urea breath test was performed 1-2 months after eradication. RESULTS: Of the 245 patients, 228 completed their treatment course. 57% were male and 43% female. Eradication rates were 76.3%, 68.4%, and 67.1% in groups A, B, and C, respectively (P=0.05). The eradication rate of drug regimen A was greater than B in males (86% vs. 63%; p<0.05), and that of B was greater than C in females (76.7 vs. 53.6%; P<0.05). CONCLUSIONS: The therapeutic regimen containing ciprofloxacin is preferable, although all drug regimens were less effective in Iran than in other parts of the world.
RCT Entities:
BACKGROUND: The eradication of Helicobacter pylori (HP) is dependent on several bacteriologic and geographic variables. Multiple-drug regimens have been tried in order to eradicate HPi; however, the optimal drug has not yet been found. MATERIAL/ METHODS: In this single-blind, randomized clinical trial, 245 dyspeptic patients with positive rapid urease tests or positive cultures for HP were entered in the study and randomly treated with one of 3 drug regimens A, B, or C for 14 days. Each regimen was administered to 76 patients. Regimen A consisted of omeprazole 20 mg bid + bismuth subcitrate 120 mg 2 tab. bid + metronidazole 250 mg 2 tab. bid + tetracycline 250 mg 2 cap. bid. Regimen B consisted of omeprazole 20 mg bid + bismuth subcitrate 120 mg 2 tab. bid + furazolidone 100 mg 2 tab. bid + tetracycline 250 mg 2 cap. bid. Regimen C consisted of omeprazole 20 mg bid + bismuth subcitrate 120 mg 2 tab. bid + ciprofloxacin 500 mg bid. A urea breath test was performed 1-2 months after eradication. RESULTS: Of the 245 patients, 228 completed their treatment course. 57% were male and 43% female. Eradication rates were 76.3%, 68.4%, and 67.1% in groups A, B, and C, respectively (P=0.05). The eradication rate of drug regimen A was greater than B in males (86% vs. 63%; p<0.05), and that of B was greater than C in females (76.7 vs. 53.6%; P<0.05). CONCLUSIONS: The therapeutic regimen containing ciprofloxacin is preferable, although all drug regimens were less effective in Iran than in other parts of the world.
Authors: Maria Pina Dore; Vincenza Tadeu; Bianca Are; Ida Mura; Giuseppe Fanciulli; Giovannino Massarelli; Andrea Piana Journal: Gastroenterol Res Pract Date: 2012-05-14 Impact factor: 2.260