V. Ahuja et al., LANSOPRAZOLE AND SECNIDAZOLE WITH CLARITHROMYCIN, AMOXICILLIN OR PEFLOXACIN IN THE ERADICATION OF HELICOBACTER-PYLORI IN A DEVELOPING-COUNTRY, Alimentary pharmacology & therapeutics, 12(6), 1998, pp. 551-555
Background: A number of triple drug regimens using proton pump inhibit
ors and two antibiotics have been evaluated in the West and reported t
o achieve Helicobacter pylori eradication rates of over 90%. In develo
ping countries however, these combinations have neither been well eval
uated, nor the optimum treatment for H, pylori infection well defined.
Aim: To compare the combination of a proton pump inhibitor with a nit
roimidazole and another antibiotic in eradicating H, pylori infection
and healing duodenal ulcer. Methods: Sixty consecutive patients with a
ctive duodenal ulcer who were positive for H, pylori (by rapid urease
test and C-14-urea breath test) were randomized into three treatments
groups: (1) LAS (n = 21): lansoprazole 30 mg o.m., amoxycillin 500 mg
q.d.s. and secnidazole 2 g on alternate days for 2 weeks; (2) LCS (n =
18): lansoprazole 30 mg o.m., clarithromycin 500 mg b.d. and secnidaz
ole 2 g on alternate days for 1 week; (3) LPS (n = 21): lansoprazole 3
0 mg o.m., pefloxacin 400 mg o,m, and secnidazole 2 g on alternate day
s for 2 weeks. Urease and breath tests were performed at 0, 6 and 12 w
eeks to check for H. pylori eradication, Results: Intention-to-treat e
radication rates were as follows: LAS 86%, LCS 83%, LPS 71%; the overa
ll ulcer healing rate was 90% at 6 weeks. Conclusions: High H. pylori
eradication rates were achieved using the amoxycillin- and clarithromy
cin-based therapies. Fewer side-effects, better compliance and low cos
t favoured the amoxycillin-based therapy.