Comparison of azithromycin and clarithromycin in triple therapy regimens for the eradication of Helicobacter pylori
| Autor: | Thomas Dunteman, Brian Sullivan, Richard Nemec, Walter J. Coyle |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Randomization medicine.drug_class Spirillaceae Antibiotics Stomach Diseases macromolecular substances Azithromycin Gastroenterology 2-Pyridinylmethylsulfinylbenzimidazoles Helicobacter Infections Double blind study Double-Blind Method Internal medicine Clarithromycin polycyclic compounds medicine Humans Lansoprazole Prospective Studies Antibacterial agent Hepatology biology Helicobacter pylori business.industry biochemical phenomena metabolism and nutrition bacterial infections and mycoses biology.organism_classification Anti-Ulcer Agents Anti-Bacterial Agents Immunology Drug Therapy Combination Female Antacids business Bismuth Omeprazole medicine.drug |
| Zdroj: | The American journal of gastroenterology. 97(10) |
| ISSN: | 0002-9270 |
| Popis: | We sought to compare an azithromycin-based regimen with an already established clarithromycin-based regimen in the eradication of Helicobacter pylori infection.A prospective, randomized, blinded comparative analysis was performed on 56 patients with upper GI symptoms who presented to the Gastroenterology Department at the Naval Medical Center Portsmouth. All patients had documented H. pylori infection on endoscopy via rapid urease test and histopathology. Patients were randomized to a treatment arm, which consisted of bismuth, clarithromycin, amoxicillin, and lansoprazole (B-LAC) or one consisting of bismuth, azithromycin, amoxicillin, and lansoprazole (B-LAA). To assess eradication, patients then received repeat endoscopy at 8 wk from entrance into the study. Rapid urease test and histopathology were again used to evaluate infection. Patients recorded all side effects. Comparison between the two groups was made using the chi2 method.Of the 56 patients included in the study, 27 went on to receive B-LAC, whereas 29 received B-LAA. The per protocol eradication rate was 84.6% with B-LAC and 55.5% with B-LAA (p = 0.021). Under intention to treat analysis, the eradication rates for B-LAC and B-LAA were 81% and 52%, respectively (p = 0.019). There was a significant difference between the two groups in number of subjects using nonsteroidal anti-inflammatory drugs (NSAIDs) (p = 0.013) and a trend toward a difference in histamine-2 (H2) blocker use (p = 0.066). Taking these two variables into account, a logistical regression was performed and continued to show a significant superiority in the B-LAC regimen (p = 0.03).The results of our study suggest that B-LAC is superior to B-LAA in the eradication of Helicobacter pylori. Our results also suggest that B-LAA is not a suitable regimen in the treatment of H. pylori because of its substandard eradication rate. |
| Databáze: | OpenAIRE |
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