CLARITHROMYCIN, AN ALTERNATIVE TO METRONIDAZOLE IN THE TRIPLE THERAPYOF HELICOBACTER-PYLORI INFECTION

Background: Triple therapy for Helicobacter pylori using metronidazole is less effective in patients with metronidazole resistant strain. Mo reover, metronidazole is responsible for many side-effects. This open study examined the efficacy and side-effects of a triple treatment reg imen substituting clarithromycin for metronidazole. Methods: 36 patien ts with a H. pylori infection, proven by culture, were treated with tr ipotassium dicitrato bismuthate 120 mg q.d.s., tetracycline 250 mg q.d .s. and clarithromycin 250 mg q.d.s. for 10 days. Eradication was defi ned as a negative culture and histological examination of antral biops y specimens, taken at least 6 weeks after completion of the treatment. Results: Eradication was achieved in 26 patients (72%). The treatment was well tolerated with only 4 (11%) of the patients having significa nt side-effects. Conclusion: Triple therapy with clarithromycin seems to be less effective than standard triple treatment when the prevalenc e of metronidazole resistance is low. It is suggested, however, that t his combination could be a valuable alternative in areas with a high p revalence of metronidazole resistance.