Ranitidine bismuth citrate versus omeprazole triple therapy for the eradication of Helicobacter pylori and healing of duodenal ulcer

Abstract

Aim: To compare the efficacy and safety of triple therapy with omeprazole plus amoxycillin and clarithromycin vs. ranitidine bismuth citrate plus amoxycillin and clarithromycin in the treatment of Helicobacter pylori‐associated duodenal ulcers. Methods: Eighty‐one patients with duodenal ulcers were randomized to the following treatments: 39 cases with amoxycillin 1 g b.d. and clarithromycin 500 mg b.d. for 1 week plus omeprazole 20 mg b.d. for 2 weeks (omeprazole + amoxycillin + clarithromycin (OAC)), and 42 cases to the same regimen of amoxycillin and clarithromycin for 7 days plus ranitidine bismuth citrate 400 mg b.d. for 2 weeks (ranitidine bismuth citrate + amoxycillin + clarithromycin (RbAC)). Upper gastrointestinal endoscopy was performed together with a rapid urease test and histological examination of antral and corpus biopsy samples prior to treatment and 4 weeks after the end of therapy. Results: Thirty‐four patients in the OAC group and 38 in the RbAC group completed the treatment and 4‐week follow‐up. H. pylori was eradicated in 30 of 34 patients (88%) in the OAC group and in 32 of 38 patients (84%) in the RbAC group according to a per‐protocol analysis (P = N.S.). Thirty‐three (97%) patients treated with OAC and 36 (95%) treated with RbAC presented healed duodenal ulcers at 4 weeks (P = N.S.). On an intention‐to‐treat basis there was no difference in H. pylori eradication between the OAC (77%) and RbAC groups (76%); duodenal ulcer healing was achieved in 85 and 86% of patients in the OAC and RbAC groups, re‐ spectively (P = N.S.). Conclusion: The OAC and RbAC triple therapy regimens proved equally effective in both H. pylori eradication and in duodenal ulcer healing.

Ranitidine Bismuth Citrate Can Help to Overcome Helicobacter pylori Resistance to Clarithromycin In Vivo

“…While the results of the dual therapy with RBC were excellent in the subgroup of patients included in this study (90%) and not far from the per protocol results from the larger study of which it is part, the global intention‐to‐treat results tended to be lower (77%) and also lower than reported in other studies [22,23]. Because triple therapies with RBC plus two antibiotics for 1 week have been recently used with success [24–27], they are currently recommended.…”

Bismuth supplements as the first‐line regimen for Helicobacter pylori eradication therapy: Systemic review and meta‐analysis

“…Overall, 2189 studies were reviewed in the literature search. The selection criteria were applied as previously described, and a total of 25 studies were eligible for the final analysis (Figure ) . All enrolled studies were limited to randomized control trials, and a 3990 patients infected with H.pylori were enrolled (Table ).…”

Efficacy of a New Therapeutic Regimen Versus Two Routinely Prescribed Treatments for Eradication of Helicobacter Pylori: A Randomized, Double-Blind Study of Doxycycline, Co-Amoxiclav, and Omeprazole in Iranian Patients

“…It also should be mentioned that some host factorsmost notably the underlying pathology or disease statemay also be involved in the overall low eradication rate observed in this study. A significant majority of our study population (90%) were cases of nonulcer dyspepsia, which is known to have a lower rate of response to H. pylori eradication compared with gastric or duodenal ulcers [27].…”