Ranitidine bismuth citrate-based triple therapy for seven days, with or without further anti-secretory therapy, is highly effective in patients with duodenal ulcer and Helicobacter pylori infection

Objective To compare the efficacy of two protocols for the eradication of H elicobacter pylori infection and the healing of active duodenal ulcer: (i) ranitidine bismuth citrate (RBC) plus two antibiotics for 7 days, and (ii) the same triple therapy followed by 3 weeks of anti-secretory drug treatmen t. Methods The study comprised 102 patients with active duodenal ulcer and H. pylori infection; the patients were randomized to open treatment with eithe r RBC 400 mg b.d. plus amoxycillin 1 g b.d. and clarithromycin 500 mg b.d, for 7 days, or the same treatment followed by 3 weeks of RBC 400 mg b.d, al one. Ulcer healing was confirmed by endoscopy. H. pylori eradication was as sessed by endoscopy, rapid urease test and histology. Results The ulcer healed in 48/50 patients on RBC-based triple therapy alon e (96.0%) and in 51/52 patients on triple therapy plus further anti-secreto ry treatment (98.1%). On an intention-to-treat basis, H. pylori had been su ccessfully eradicated in 42/50 patients on triple therapy (84.0%) and in 44 /52 patients on triple therapy plus anti-secretory treatment (84.6%), while by per protocol analysis the H. pylori eradication rates were 91.3% (42/46 ) and 89.8% (44/49), respectively. Conclusions One-week triple therapy with RBC, amoxycillin and clarithromyci n is highly effective in eradicating H. pylori and healing duodenal ulcers, even if not followed by anti-secretory drug treatment. Eur J Gastroenterol Hepatol 13:547-550 (C) 2001 Lippincott Williams & Wilkins.