HELICOBACTER-PYLORI ERADICATION USING ONE-WEEK LOW-DOSE LANSOPRAZOLE PLUS AMOXICILLIN AND EITHER CLARITHROMYCIN OR AZITHROMYCIN

Aim: To evaluate and compare two 1-week low-dose triple therapies base d on lansoprazole, amoxycillin and a macrolide in eradicating Helicoba cter pylori. Methods: Seventy consecutive patients, suffering from dys peptic symptoms with H. pylori infection, were randomly allocated to o ne of two treatment groups: (A) (LAG; n = 35) lansoprazole 30 mg once daily, amoxycillin 1000 mg b.d., clarithromycin 250 mg b.d., all for 7 days; and (B) (LAA; n = 35) lansoprazole 30 mg once daily and amoxyci llin 1000 mg b.d., both for 7 days, plus azithromycin 500 mg once dail y for only 3 days. The H. pylori status was evaluated by means of hist ology and rapid urease test at entry and 8 weeks after treatment. Resu lts: Three patients did not complete the treatment: one in the LAC gro up was withdrawn owing to severe side-effects; two patients in the LAA group stopped the treatment prematurely. H. pylori eradication was ob tained in 28 of 34 (82%; 95% CI = 66-93%) patients in the LAC group an d in 20 of 33 (61%; 95% CI = 42-77%) patients in the LAA group. The di fference is significant (P < 0.029). On intention-to-treat analysis, t he rates of eradication were (28 of 35 patients, 80% in the LAC group and 20 of 35 patients, 57% in the LAA group. Side-effects occurred in nine (26%) and six (18%) patients in the LAC and LAA groups, respectiv ely. Conclusions: Low-dose lansoprazole plus amoxycillin and clarithro mycin is more effective than low-dose lansoprazole plus amoxycillin an d azithromycin, but it gave a greater incidence of side-effects.