Bismuth-containing single-antibiotic 1-week triple therapy for Helicobacter pylori eradication.
BACKGROUND
Although bismuth was both the first drug shown to alter the natural history of peptic ulcer disease and also a constituent of the first very effective eradication regimens, it has been excluded from the newer regimens, despite its safety and low cost, in favour of two antibiotics.


OBJECTIVE
To asses a novel 1-week regimen consisting of bismuth, clarithromycin and a proton pump inhibitor in routine clinical practice.


METHODS
One hundred and three consecutive patients with peptic ulcer disease and antral biopsies containing Helicobacter pylori were given a 7-day course of treatment with bismuth (tripotassium dicitrato bismuthate chelate) 120 mg q.d.s., clarithromycin 500 mg t.d.s. and lansoprazole 30 mg o.d. Completeness of eradication was assessed by a l3C-urea breath test, in all except three patients, at least 4 months later.


RESULTS
Of the 100 patients who were assessed in this open treatment study 84 (84%; 95% CI: 77-91%) had a negative breath test. Minor side-effects were reported by 14% and more troublesome side-effects (nausea, vomiting, diarrhoea, hallucinations, nasty taste and body pains) were reported by 10%.


CONCLUSIONS
A 1-week course of triple therapy including bismuth, clarithromycin and a proton pump inhibitor is effective in routine clinical practice and is well tolerated.
Scott
B B
BB
Department of Medicine, County Hospital, Lincoln, UK.
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D015746:Abdominal Pain / Q000139:chemically induced; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000863:Antacids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001004:Anus Diseases / Q000139:chemically induced; D001729:Bismuth / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001944:Breath Tests; D002247:Carbon Isotopes; D017291:Clarithromycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003967:Diarrhea / Q000139:chemically induced; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006212:Hallucinations / Q000139:chemically induced; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009853:Omeprazole / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D011247:Pregnancy; D011500:Protein Synthesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D054328:Proton Pump Inhibitors; D013651:Taste Disorders / Q000139:chemically induced; D013997:Time Factors; D014060:Tongue Diseases / Q000139:chemically induced; D016896:Treatment Outcome; D014508:Urea; D014839:Vomiting / Q000139:chemically induced
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000863:Antacids; D000900:Anti-Bacterial Agents; D002247:Carbon Isotopes; D004791:Enzyme Inhibitors; D011500:Protein Synthesis Inhibitors; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D014508:Urea; D017291:Clarithromycin; D009853:Omeprazole; D001729:Bismuth