Six-day therapy with ranitidine bismuth citrate plus low-dose clarithromycin and tinidazole to cure Helicobacter pylori infection

Background/Aims: Short-term ranitidine bismuth citrate-based triple regimen s have been shown to be effective for the eradication of H.pylori. We inves tigated the efficacy of an eradicating therapy including ranitidine bismuth citrate, low-dose clarithromycin and tinidazole, administered for only 6 d ays. Methodology: Forty-five consecutive patients, who underwent gastroscopy; fo r symptoms and were found to be H.pylori-positive, were recruited. They rec eived ranitidine bismuth citrate 400mg b.i.d. plus clarithromycin 250mg b.i .d. plus tinidazole 500mg b.i.d., given for 6 days. The medications given i n twice daily doses were taken after meals with an interval of 12 h. The H. pylori status was evaluated by means of histology and rapid urease test on admission, and by C-13-urea breath test alone 8 weeks after treatment. Results: All 45 enrolled patients completed the study. Thirty-nine of 45 pa tients returned H.pylori-negative (both per protocol and intention-to-treat analysis = 87%; 95% confidence interval = from 73-95%), while 6 of 45 were still H.pylori-positive (13%). Slight or mild side effects occurred in 5/4 5 patients (11%). Conclusions: Ranitidine bismuth citrate-based triple therapy, containing lo w-dose clarithromycin and tinidazole, given for only 6 days, yielded high e radication rates with modest side effects. Regimens based on ranitidine bis muth citrate plus two antibiotics at low dosages, administered for less tha n 7 days, constitute highly promising strategies for eradication of H.pylor i.