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document
Prospective evaluation of the macrolide antibiotic dirithromycin for the treatment of Helicobacter pylori . BACKGROUND Macrolide antibiotics are active in vitro and in vivo against Helicobacter pylori . We assessed a newer macrolide , dirithromycin , for the treatment of H. pylori in two separate studies . METHODS Volunteers with H. pylori infection ( by 13C-urea breath test ) were randomly assigned to 2-week treatment regimens . Study 1 : dirithromycin 500 mg q.d.s. , dirithromycin 500 mg q.d.s . plus omeprazole 40 mg q.d.s. , or dirithromycin 500 mg q.d.s . plus metronidazole 500 mg t.d.s . Study 2 : dirithromycin 500 mg q.d.s . plus omeprazole 20 mg b.d. , dirithromycin 1000 mg q.d.s . plus omeprazole 20 mg b.d. , or amoxycillin 500 mg q.d.s . plus omepirazole 20 mg b.d . Four weeks after the completion of therapy a repeat 13C-urea breath test was done to assess for cure . RESULTS No patient taking dirithromycin alone ( n = 6 ) or in combination with omeprazole ( n = 26 ) achieved cure of their infection . Eradication of H. pylori was seen in one of seven patients taking dirithromycin plus metronidazole . Five of 10 patients taking omeprazole-amoxycillin dual therapy had their H. pylori infection cured ( P = 0.0007 vs. patients taking dirithromycin plus omeprazole ) . Eleven ( 47 % ) of 32 patients taking dirithromycin alone or combined with omeprazole reported side-effects , but only two ( 6 % ) stopped therapy prematurely as a result of side-effects . CONCLUSION No subject taking dirithromycin alone or in combination with omeprazole had their H. pylori infection cured . Dirithromycin , in the regimen used , shows little promise in the treatment of patients with H. pylori infection .
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Intervention_Pharmacological
macrolide antibiotic dirithromycin
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Intervention_Pharmacological
Macrolide antibiotics
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Intervention_Pharmacological
macrolide , dirithromycin
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Intervention_Pharmacological
dirithromycin 500 mg q.d.s.
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Intervention_Pharmacological
dirithromycin 500 mg q.d.s . plus omeprazole 40 mg q.d.s.
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Intervention_Pharmacological
or dirithromycin 500 mg q.d.s . plus metronidazole 500 mg t.d.s .
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Intervention_Pharmacological
dirithromycin 500 mg q.d.s . plus omeprazole 20 mg b.d.
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Intervention_Pharmacological
dirithromycin 1000 mg q.d.s . plus omeprazole 20 mg b.d.
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Intervention_Pharmacological
or amoxycillin 500 mg q.d.s . plus omepirazole 20 mg b.d .
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Intervention_Pharmacological
dirithromycin
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Intervention_Pharmacological
omeprazole
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Intervention_Pharmacological
dirithromycin
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Intervention_Pharmacological
metronidazole .
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Intervention_Pharmacological
omeprazole-amoxycillin
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Intervention_Pharmacological
dirithromycin
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Intervention_Pharmacological
omeprazole )
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Intervention_Pharmacological
dirithromycin
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Intervention_Pharmacological
omeprazole
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Intervention_Pharmacological
dirithromycin
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Intervention_Pharmacological
omeprazole
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Intervention_Pharmacological
Dirithromycin
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Outcome_Physical
cure of their infection
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Outcome_Other
Eradication of H. pylori
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Outcome_Other
pylori infection cured
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Outcome_Adverse-effects
reported side-effects
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Outcome_Adverse-effects
side-effects
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Outcome_Other
cured
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Participant_Condition
Helicobacter pylori
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Participant_Condition
Helicobacter pylori
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Participant_Condition
H. pylori
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Participant_Condition
H. pylori