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document
Efficacy and tolerability of antibiotics in patients undergoing H. pylori eradication . BACKGROUND/AIMS Helicobacter pylori ( H. pylori ) infection is one of the most common gastrointestinal diseases . An increasing number of people undergo different treatment options . Unfortunately , H. pylori therapy may be troublesome for drug side effects and inefficacious for resistance to antibiotics . METHODOLOGY One hundred and ninety-three ( 193 ) H. pylori-positive patients were randomly assigned to one of the following 7-day treatments : Group A ( N = 64 ) : amoxicillin , clarithromycin and rabeprazole ; Group B ( N = 64 ) : tinidazole , clarithromycin and ranitidine bismuth citrate ; Group C ( N = 65 ) : tinidazole , clarithromycin and rabeprazole Eradication was assessed by 13C-Urea Breath Test 6-8 weeks after the end of the therapy . Not-eradicated patients underwent a second cycle with tinidazole , tetracycline , bismuth and rabeprazole . All patients were asked to complete a validated questionnaire regarding presence and intensity of drug side effects . RESULTS One hundred and eighty-eight out of the 193 H. pylori-positive patients ( 96 % ) completed therapy . No significant difference in eradication rates was observed among the three groups both in intention to treat analysis and in per protocol analysis . No significant difference in incidence of side effects occurred among groups after the first-line regimens : 48 % in group A , 44 % in group B and 46 % in group C. Twenty-two out of the 193 enrolled subjects ( 11 % ) were not eradicated after the first-line therapy . Among them , 86 % were successfully eradicated by the tinidazole , tetracycline , bismuth and rabeprazole therapy . Moreover , during quadruple therapy , a higher prevalence and intensity of side effects than in each one of the groups submitted to the first-line triple therapy was observed . CONCLUSIONS This study shows that triple rabeprazole-based eradicating regimens are effective and safe . Incidence of side effects seems low and similar in different three-drug regimens used . Quadruple therapy , which appear highly efficacious as a second line therapy , is associated with a significantly higher incidence of side effects when compared to first-line treatment .
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Intervention_Pharmacological
antibiotics
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Intervention_Pharmacological
antibiotics
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Intervention_Pharmacological
amoxicillin , clarithromycin and rabeprazole
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Intervention_Pharmacological
tinidazole , clarithromycin and ranitidine bismuth citrate
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Intervention_Pharmacological
tinidazole , clarithromycin and rabeprazole
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Intervention_Pharmacological
tinidazole , tetracycline , bismuth and rabeprazole
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Intervention_Pharmacological
tinidazole , tetracycline , bismuth
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Intervention_Pharmacological
rabeprazole
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Intervention_Pharmacological
triple rabeprazole-based eradicating regimens
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Intervention_Pharmacological
Quadruple therapy
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Outcome_Other
Efficacy and tolerability
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Outcome_Physical
eradication rates
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Outcome_Adverse-effects
incidence of side effects
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Outcome_Physical
eradicated
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Outcome_Physical
eradicated
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Outcome_Adverse-effects
prevalence and intensity of side effects
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Outcome_Other
effective and safe .
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Outcome_Adverse-effects
side effects
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Participant_Sample-size
One hundred and ninety-three ( 193 )
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Participant_Condition
H. pylori-positive patients
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Participant_Condition
Group A
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Participant_Sample-size
64
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Participant_Condition
Group B
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Participant_Sample-size
64 )
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Participant_Condition
Group C
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Participant_Sample-size
65