Portal de Periódicos da CAPES

Triple regimens using lansoprazole or ranitidine bismuth citrate for Helicobacter pylori eradication

1998; Wiley; Volume: 12; Issue: 10 Linguagem: Inglês

10.1046/j.1365-2036.1998.00392.x

1365-2036

Spadaccini, Fanis, Sciampa, Russo Russo, Silla, Pantaleone, Virgilio, Pizzicanella,

Gastroesophageal reflux and treatments

Background: A combination of an antisecretory agent with two antibiotics is considered the ‘gold standard’ for Helicobacter pylori eradication. Objectives: To compare the eradication rates and the safety profile of two short‐term triple therapies containing lansoprazole (L) or ranitidine bismuth citrate (RBC) as antisecretory agents. Methods: One hundred and twelve H. pylori ‐positive patients either with peptic ulcer (56 duodenal ulcers: 25 active and 31 with a history of ulcer; 13 gastric ulcers: nine active and four with a history of ulcer) or gastritis (43) were included in an open, randomized, controlled trial. H. pylori infection was initially detected by CLO‐test and histology on antral and corpus biopsies . H.␣pylori ‐positive patients were randomized to receive L plus clarithromycin (C) 250 mg b.d. plus tinidazole (T) 500 mg b.d. (LCT) or RBC plus C 250 mg b.d. and T 500 mg b.d. for 7 days (RbcCT). L or RBC were administered for a further 3 weeks in patients with active peptic ulcers. A second endoscopy was performed at least 6 weeks after the end of therapy for the assessment of H. pylori infection by CLO‐test and histology. Eradication was assumed if all the tests were negative for H. pylori . Results: Forty‐eight patients in the LCT group and 45 in the RbcCT group were assessed for H. pylori eradication. The eradication rates, according to intention‐to‐treat (ITT) and per protocol (PP) analyses were, respectively, 76.8% and 89.5% for the LCT group, and 73.2% and 91.1% for the RbcCT group. No statistically significant difference in eradication rates was found between the two groups by Mantel–Haenszel test. All peptic ulcers were healed. In patients in whom H. pylori had been eradicated, the severity of gastritis was significantly reduced. Side‐effects were rare. One patient in the LCT group and two in the RbcCT group were withdrawn because of adverse events. Conclusion: Short‐term triple therapy with either lansoprazole or RBC is equally effective and well tolerated.