Low dose of clarithromycin in triple therapy for the eradication of Helicobacter pylori: One or two weeks?

N. Dal Bo', F. Di Mario, G. Battaglia, A. Buda, G. Leandro, F. Vianello, S. Kusstatscher, S. Salandin, A. Pilotto, M. Cassaro, S. Vigneri, M. Rugge

Research output: Contribution to journalArticlepeer-review

Abstract

The aims of this pilot study were: (1) to compare the efficacy of low- dose clarithromycin (250 mg twice daily) for 1 or 2 weeks; and (ii) to evaluate possible therapeutic advantages in associating the low-dose clarithromycin with an anti-secretory agent or tripotassium dicitrate bismuthate (De Nol; Yamanouchi Pharm, Corugate Milano, Italy). A prospective, randomized, open trial was carried out on consecutive outpatients with dyspeptic symptoms and Helicobacter pylori infection. We enrolled 129 patients in one of the following schedules: (A) De Nol 120 Mg q.i.d., clarithromycin 250 mg b.i.d. and metronidazole 250 mg q.i.d. for 2 weeks; (B) omeprazole 20 mg b.i.d., clarithromycin 250 mg b.i.d. and metronidazole 250 mg q.i.d. for 2 weeks; or (C) omeprazole 20 mg b.i.d., clarithromycin 250 mg b.i.d. and metronidazole 250 mg q.i.d. for 1 week. Results were evaluated by Per Protocol (PP) and Intention-To-Treat analysis (ITT). Eradication rate was 100% after treatment A, 92.6% after treatment B and 86.5% after treatment C by PP and 83.3, 75.7, and 68.1%, respectively by ITT. Side effects were reported by 16 subjects: 26.6% in group A; 9.1% in group B; and 7.5% in group C; in two cases side effects led to the withdrawal of the treatment. In conclusion, 500 mg clarithromycin per day in association with omeprazole and metronidazole, for 1 week gave comparable results to the same schedule for a 2 week period. The use of clarithromycin with bismuth and metronidazole produced a therapeutic gain compared with both of the anti-secretory schedules, although this was not statistically significant.

Original languageEnglish
Pages (from-to)288-293
Number of pages6
JournalJournal of Gastroenterology and Hepatology
Volume13
Issue number3
Publication statusPublished - 1998

Keywords

  • Clarithromycin
  • Helicobacter pylori eradication
  • Triple therapy

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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