OMEPRAZOLE PLUS CLARITHROMYCIN AND EITHER TINIDAZOLE OR TETRACYCLINE FOR HELICOBACTER-PYLORI INFECTION - A RANDOMIZED PROSPECTIVE-STUDY

Objective: Helicobacter pylori has begun to show resistance to imidazo les and could result in the low efficacy of short-term triple therapy, The aim of this study was to assess whether administration of tetracy cline instead of tinidazole in short-term low-dose triple therapy coul d increase the H. pylori eradication rate, Methods: In a prospective s tudy, 113 patients with peptic ulcer (n = 36) or non-ulcer dyspepsia ( n = 77) were randomized to receive 1-wk treatment, composed of omepraz ole 20 mg b.i.d., clarithromycin 250 mg b.i.d., and either tinidazole 500 mg b.i.d. (n = 57) or tetracycline 500 mg b.i.d. (n = 56), upon de tection of H. pylori infection at endoscopy, Results: H. pylori eradic ation, defined as a negative bacterial finding in a rapid urease test and upon histologic assessment at least 4 wk after cessation of therap y, was achieved in 86% (49 of 57; 95% confidence interval = 76.9 - 95) of patients in the first group and in 71.4%, (40 of 56; 95% confidenc e interval = 59.6 - 83.3) in the second group (p = not significant), S ide effects occurred in 28% of patients from the tinidazole-based grou p and in 12.5% from the tetracycline group (p = not significant), Two patients in the tinidazole group discontinued therapy at 5 and 6 days because of side effects, Conclusions: The administration of tetracycli ne instead of tinidazole in short-term triple therapy yielded disappoi nting results in H. pylori eradication.