Comparison of ranitidine and lansoprazole in short‐term low‐dose triple therapy for Helicobacter pylori infection

Abstract

Aim: To evaluate the efficacy and safety of two 1‐week low‐dose triple‐therapy drug regimens involving antisecretory drugs for Helicobacter pylori infection, 99␣patients with H. pylori infection were treated with either lansoprazole or ranitidine used together with clarithromycin and metronidazole. Methods: The drug combination and administration periods in the proton pump inhibitor group were lansoprazole 30 mg o.m., clarithromycin 200 mg b.d. and metronidazole 250 mg b.d., all given for 7 days (LCM group). The ranitidine group received ranitidine 150 mg b.d., clarithromycin 200 mg b.d. and metronidazole 250 mg b.d. also for 7 days (RCM group). The presence or absence of H. pylori was determined from gastric biopsy specimens taken from both the antrum and the body, by smear, culture and tissue section (Giemsa stain). Cure was defined as failure to find evidence of H. pylori infection 4 weeks after antimicrobial therapy had ended. Results: The cure of H. pylori infection was 88% in the LCM group (44 of 50; 95% confidence interval (CI) = 79–97%) and 92% in the RCM group (45 of 49; 95% CI = 84–99%). The incidence of adverse events was 16% and 18% for the two groups, respectively. Conclusions: No significant differences in cure rate and safety profiles were noted between the two regimens, suggesting that moderate acid inhibition using an H2‐blocker is sufficient to achieve optimal H. pylori eradication.

Head‐to‐head comparison of 1‐week triple regimens combining ranitidine or omeprazole with two antibiotics to eradicate Helicobacter pylori

“…The low power of this study, however, does not allow us to conclude that ranitidine‐ and omeprazole‐based regimens can be considered equivalent. However, our findings achieved in a trial comparing head‐to‐head proton pump inhibitor‐ and H 2 ‐RA‐based triple therapies reinforces the results reported in previous studies assessing the efficacy of these drug combinations separately or together in small sample trials, 13 –21 and leads us to question the importance of profound acid suppression in the eradication of the bacterium.…”

Optimal duration of therapy combining ranitidine bismuth citrate with clarithromycin and metronidazole in the eradication of Helicobacter pylori infection

“…An additional explanation may be that the more profound and prolonged acid inhibition that is induced by proton pump inhibitors compared to H 2 antagonists 19 is better able to potentiate the antibiotic action, even though it has been shown in many studies that proton pump inhibitors and H 2 blockers combined with identical antimicrobial agents provide similar eradication efficacy 20 –22…”

Lafutidine, a Novel Histamine H2‐Receptor Antagonist, vs. Lansoprazole in Combination with Amoxicillin and Clarithromycin for Eradication of Helicobacter pylori

“…122 outpatients with positive cultures and subsequent successful cultivation of H. pylori for antimicrobial susceptibility tests were randomized to receive a 7‐day course of either lafutidine (20 mg twice daily) or lansoprazole (30 mg twice daily), plus clarithromycin (200 mg twice daily) and amoxicillin (750 mg twice daily). Eradication was considered successful if the rapid urease test, culture, histology and [13]C‐urea breath test were all negative at least 4 weeks after cessation of therapy. Cytochrome p450 2C19 genotype status using polymerase chain reaction‐restriction fragment length polymorphism was also studied. Results.…”

“…This may be the major reason for selecting proton pump inhibitor over H 2 receptor antagonist in eradication therapies for H. pylori . However, it is known that acid secretion is weaker in Japanese subjects relative to that in Caucasians [13], and one may wonder whether profound inhibition of acid secretion, such as that achieved with proton pump inhibitor, is really necessary to achieve a high cure rate of H. pylori infection in the Japanese population. Furthermore, it remains unresolved whether substitution of proton pump inhibitor with H 2 receptor antagonist in the new triple therapy regimen would yield similar results.…”