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Triple or Quadruple Tetracycline-Based Therapies Versus Standard Triple Treatment for Helicobacter pylori Treatment

2009; Elsevier BV; Volume: 338; Issue: 1 Linguagem: Inglês

10.1097/maj.0b013e31819c7320

1538-2990

Yıldıran Songür, Altuğ Şenol, Ayşe Balkarlı, Abdulkadir Baştürk, Süreyya Çerçi,

Intestinal and Peritoneal Adhesions

Abstract Background Our aim was to compare lansoprazole-tetracycline-metranidazole (LTM) as first-line treatment with the classical lansoprazole-amoxicillin-clarithromycin (LAC) and bismuth-containing quadruple treatments. Patients and Methods This prospective, single-center, randomized study included 464 consecutive Helicobacter pylori –positive patients with dyspeptic symptoms. A total of 415 patients completed the study. The patients were allocated into 4 study groups using random sampling numbers as follows—LAC group: lansoprazole 30mg twice daily, amoxicillin 1000mg twice daily, and clarithromycin 500mg twice daily for 14 days; BLTM group: bismuth subcitrate 300mg 4 times a day, lansoprazole 30mg twice daily, tetracycline 500mg 4 times a day, and metronidazole 500mg twice daily for 10days; RBLTM group: ranitidine bismuth citrate 400mg twice daily, lansoprazole 30mg twice daily, tetracycline 500mg 4 times a day, and metronidazole 500mg twice daily for 10 days; and LTM group: lansoprazole 30mg twice daily, tetracycline 500mg 4 times a day, and metronidazole 500mg twice daily for 10 days. Results The per protocol H . pylori eradication rate in LAC, BLTM, RBLTM, and LTM groups were 37 of 104 (35.6%), 56 of 102 (54.9%), 67 of 104 (64.4%), and 63 of 105 (60%), respectively. The intention–to–treat eradication rate was 37 of 113 (32.7%) in LAC, 56 of 119 (47.1%) in BLTM, 67 of 117 (57.3%) in RBLTM, and 63 of 115 (54.8%) in LTM group. The BLTM, RBLTM, and LTM treatment groups achieved a significantly better eradication rate than the LAC treatment group ( P <0.001). There was not any significant statistical difference between the groups of BLTM, RBLTM, and LTM. Conclusion LTM treatment group achieved a significantly better eradication rate than the LAC treatment group. The success ratio of LTM therapy is comparable with quadruple bismuth-based treatments.