title: Triple therapy with ranitidine, clarithromycin, and metronidazole in the treatment of Helicobacter pylori.
abstract: BACKGROUND
  To determine whether a triple therapy regimen for the treatment of Helicobacter pylori infection, consisting of ranitidine 300 mg q.i.d., clarithromycin 500 mg t.i.d., and metronidazole 500 mg t.i.d. would provide a safe and effective treatment regimen, we performed an open prospective study in 20 consecutive patients with proven H. pylori-associated non-ulcer dyspepsia or peptic ulcer disease.
  
  
  METHODS
  The percentage of patients in whom eradication of H. pylori succeeded was determined. A semiquantitative assessment of histology was performed, and the results were analysed using Wilcoxon's matched-pairs ranks tests; side effects were noted and graded.
  
  
  RESULTS
  Eradication was achieved in 19 of 20 patients, i.e. in 95% (confidence interval 85-100%). Eradication of the bacterium led to a significant improvement in semiquantitative histology scores; active antral inflammation decreased from (mean +/- SEM) 1.84 +/- 0.19 to 0.21 +/- 0.16 (p = 0.0004) and chronic antral inflammation from 2.47 +/- 0.14 to 1.16 +/- 0.14 (p = 0.0002); active gastric body inflammation decreased from 0.95 +/- 0.19 to 0.00 +/- 0.00 (p = 0.0015) and chronic inflammation from 1.68 +/- 0.17 to 0.32 +/- 0.11 (p = 0.0007). Side effects occurred in 45% of patients, but in over half of these patients only mild side effects occurred. Severe side effects did not occur, none of the patients discontinued the triple therapy.
  
  
  CONCLUSIONS
  Triple therapy with ranitidine, clarithromycin, and metronidazole provides a safe and effective treatment of H. pylori infection, resulting in a high eradication rate, and in significant decrease in semiquantitative histology scores. Further prospective studies are warranted.
authors.affiliation: Dept. of Gastroenterology-Hepatology, University Hospital Leiden, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Götz
authors.forename: R A
authors.initials: RA
authors.lastname: Veenendaal
authors.forename: M
authors.initials: M
authors.lastname: Veselic
authors.forename: S
authors.initials: S
authors.lastname: Bernards
authors.forename: C B
authors.initials: CB
authors.lastname: Lamers
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017291:Clarithromycin / Q000009:adverse effects / Q000627:therapeutic use*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification; D006635:Histamine H2 Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008795:Metronidazole / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology; D011446:Prospective Studies; D011899:Ranitidine / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D008795:Metronidazole; D011899:Ranitidine; D017291:Clarithromycin