Ranitidine bismuth citrate with low-dose clarith-romycin and metronidazole for one week gives high rates of H. pylori eradication

One‐week clarithromycin triple therapy regimens for eradication of Helicobacter pylori

“…Pooling data from nine studies with 10 treatment arms of R 400 mg b.d. + C + M 16 , 21 , 120 –126 gave an ITT eradication rate of 88.7% ( n = 702/791); range 82–98% 120 , . 123 Little difference was found between C 500 mg b.d 120 –123 , .…”

“…Reports of 10 studies with ranitidine bismuth citrate, clarithromycin and amoxycillin (RCA) were found 13–22. ITT eradication rates were available from all but one,22 giving a pooled rate of 82.0% ( n = 427/521); range 39–94% 19.…”

“…Double‐blind, randomized studies were reported by Hetzel et al 16 . and by Wetterhus et al 21 . Both included patients with non‐ulcer dyspepsia, with or without a history of duodenal ulcer.…”

The influence of metronidazole resistance on the efficacy of ranitidine bismuth citrate triple therapy regimens for Helicobacter pylori infection

“…Confirming the results of other investigators, the first part of our study shows that triple therapy with ranitidine bismuth citrate, clarithromycin and metronidazole effectively eradicates H. pylori. 19 –28 Furthermore, the study shows that metronidazole resistance does not influence the efficacy of RMC to a significant degree. In that aspect, our data confirm the preliminary results of Bardhan et al ., who found a per protocol eradication rate of 100% ( n = 33) in patients infected with a metronidazole‐susceptible strain and of 90% ( n = 10) in patients infected with a resistant strain ( P = 0.25, Fisher's exact test) 20 .…”

Reply—clarithromycin‐based triple therapies

“…Dr Huang and Professor Hunt's comment that all patients in RBC‐based triple therapy studies were receiving eradication therapy for the first time is incorrect. Our international RBC protocols specifically do not exclude such patients 12 –14 …”