TRIPLE THERAPY WITH SUCRALFATE IS NOT EFFECTIVE IN ERADICATING HELICOBACTER-PYLORI AND DOES NOT REDUCE DUODENAL-ULCER RELAPSE RATES

Objectives: The most used therapeutic schedule to eradicate Helicobact er pylori is the ''triple therapy,'' which is based on the simultaneou s use of a bismuth salt and two antibiotics. Sucralfate, a basic alumi num salt of sucrose sulfate, is supposed to have an antibacterial acti vity and is said to reduce the bacterial density of H. pylori. This ra ndomized, prospective clinical trial compares the efficacy of an alter native oral triple therapy consisting of sucralfate, tinidazol, and te tracycline with a conventional therapy using ranitidine, with respect to H. pylori eradication and duodenal ulcer healing and recurrence in a 12-month follow-up. Methods: Forty-three patients with active duoden al ulcers diagnosed at endoscopy were enrolled to receive either 1 g o f sucralfate four times daily for 30 days, 500 mg of tetracycline four times daily, and 500 mg of tinidazol three times daily, for 10 days ( group A; n = 23) or 150 mg of ranitidine twice daily for 30 days (grou p B; n = 20). The groups were age- and sex-matched and balanced for to bacco use and H. pylori status. Compliance assessed by post-treatment interviews was considered high (all patients declared that they had in gested at least 80% of the drugs). Results: Both therapies were effici ent in healing ulcers (group A, 95%; group B, 90%), the relapse rates were high in both groups (group A, 77%; group B, 89%), and the alterna tive triple therapy eradicated H. pylori in only 4% of the patients. C onclusion: Alternative oral triple therapy presented no significant ad vantage over ranitidine treatment of active ulcer disease.