HIGHLY EFFECTIVE 2ND-LINE ANTI-HELICOBACTER PYLORI THERAPY IN PATIENTS WITH PREVIOUSLY FAILED METRONIDAZOLE-BASED THERAPY

Background: In this study we compared the cure rates of two clarithrom ycin-based regimens in patients in whom anti-Helicobacter pylori thera py had previously failed. Methods: Thirty-three patients were randomiz ed to receive either regimen OAC (20 mg omeprazole, 750 mg amoxicillin , and 250 mg clarithromycin) or BTC (240 mg bismuth subcitrate, 750 mg oxytetracycline, and 250 mg clarithromycin), all twice daily for 10 d ays. A further 28 patients were all treated with OAC. Previously faile d therapy included combinations of bismuth (B), omeprazole (O), tetrac ycline (T), metronidazole (M), amoxicillin (A), or clarithromycin (C) in BTM (n = 48), OAM (n = 13), OA (n = 7), OCM (n = 2), or BCM (n = 1) . H. pylori infection was confirmed by culture of biopsy specimens, an d antimicrobial susceptibility testing was performed with the E test. Results: H. pylori infection was cured in all patients (n = 18) with O AC and in 8 patients (53%) with BTC (P = 0.001) in the randomized grou p and in 27 patients (96%) receiving OAC in the open-label group. Conc lusions: Ten-day OAC is highly effective and superior to ETC in patien ts in whom metronidazole-based treatment has previously failed.