TRIPLE THERAPY WITH RANITIDINE, CLARITHROMYCIN, AND METRONIDAZOLE IN THE TREATMENT OF HELICOBACTER-PYLORI

Background: To determine whether a triple therapy regimen for the trea tment of Helicobacter pylori infection, consisting of ranitidine 300 m g q.i.d., clarithromycin 500 mg t.i.d., and metronidazole 500 mg t.i.d . would provide a safe and effective treatment regimen, we performed a n open prospective study in 20 consecutive patients with proven H. pyl ori-associated non-ulcer dyspepsia or peptic ulcer disease. Methods: T he percentage of patients in whom eradication of H. pylori succeeded w as determined. A semiquantitative assessment of histology was performe d, and the results were analysed using Wilcoxon's matched-pairs ranks tests; side effects were noted and graded. Results: Eradication was ac hieved in 19 of 20 patients, i.e. in 95% (confidence interval 85-100%) . Eradication of the bacterium led to a significant improvement in sem iquantitative histology scores; active antral inflammation decreased f rom (mean +/- SEM) 1.84 +/- 0.19 to 0.21 +/- 0.16 (p = 0.0004) and chr onic antral inflammation from 2.47 +/- 0.14 to 1.16 +/- 0.14 (p = 0.00 02); active gastric body inflammation decreased from 0.95 +/- 0.19 to 0.00 +/- 0.00 (p = 0.0015) and chronic inflammation from 1.68 +/- 0.17 to 0.32 +/- 0.11 (p = 0.0007). Side effects occurred in 45% of patien ts, but in over half of these patients only mild side effects occurred . Severe side effects did not occur, none of the patients discontinued the triple therapy. Conclusions: Triple therapy with ranitidine, clar ithromycin, and metronidazole provides a safe and effective treatment of H. pylori infection, resulting in a high eradication rate, and in s ignificant decrease in semiquantitative histology scores. Further pros pective studies are warranted.