RANITIDINE BISMUTH CITRATE WITH CLARITHROMYCIN FOR THE ERADICATION OFHELICOBACTER-PYLORI AND FOR ULCER HEALING

Background. In a pilot study, ranitidine bismuth citrate (RBC; Pylorid , Tritec) in coprescription with clarithromycin achieved a Helicobacte r pylori eradication rate (based on C-13 urea breath test alone) of 83 %. The aim of the current study was to validate this finding by using three diagnostic tests and a larger group of H. pylori-positive patien ts with active duodenal ulcer. Methods. In a blinded study, 95 patient s were given either 4 weeks of treatment with RBC, 400 mg bid, alone ( RBC400, n = 31) or RBC, 400 mg bid or 800 mg bid, in coprescription wi th clarithromycin, 250 mg qid for 14 days, followed by 14 days of RBC, 400 mg bid, alone (RBC400 + CLAR and RBC800 + CLAR, respectively; n = 32 for each). Rates of ulcer healing at week 4 and of H. pylori eradi cation (assessed by antral and corpus urease tests and histology and b y (13) urea breath test) at week 8 were compared, together with the in cidence of adverse events. Results. All three regimens were effective at duodenal ulcer healing and were tolerated well. The coprescription regimens gave significantly higher observed H. pylori eradication rate s (82% and 74% for RBC400 + CLAR and RBC800 + CLAR) compared with RBC4 00 (0%; p < .001). Conclusions. RBC in dual therapy with clarithromyci n provides excellent H. pylori eradication therapy and is an effective duodenal ulcer healing drug.