title: Poor efficacy of ranitidine bismuth citrate-based triple therapies for Helicobacter pylori eradication.
abstract: BACKGROUND
  Helicobacter pylori eradication rates have tended to decrease recently possibly related with increasing antibiotic resistance. The present study investigated the efficacy of three different ranitidine bismuth citrate (RBC) based triple regimens in a population with high prevalence of H. pylori.
  
  
  METHODS
  300 consecutive H. pylori positive patients with non-ulcer dyspepsia were randomized into three regimens: (1) RBC 400 mg, amoxicillin 1000 mg and tetracycline 500 mg [RBC-AT], (2) RBC 400 mg, amoxicillin 1000 mg and clarithromycin 500 mg [RBC-AC], (3) RBC 400 mg, metronidazole 500 mg and tetracycline 500 mg [RBC-MT]. Tetracycline was given q.i.d, all other drugs were given b.i.d. for 14 days. Gastroscopy and (14)C-Urea breath test (UBT) were performed before enrollment and UBT only was repeated 6 weeks after the end of treatment.
  
  
  RESULTS
  274 patients completed the protocols. The overall 'intention to treat' and 'per protocol' H. pylori eradication rates in all subjects were 57.6% (95% CI: 52-63) and 63.1% (95% CI: 57-68), respectively. The eradication rates achieved in the groups (RBC-AT, RBC-AC and RBC-MT) were 64.4% (95% CI: 54-74), 66.2% (95% CI: 56-76), and 58.9% (95% CI: 49-68) on 'per protocol' analyses, respectively. There was no difference in eradication rates, compliance and major side effects between the groups.
  
  
  CONCLUSIONS
  The current RBC-based H. pylori eradication therapy is not adequately effective.
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, University of Gaziantep, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Uygun
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Kadayifci
authors.forename: Zeki
authors.initials: Z
authors.lastname: Yesilova
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Ates
authors.forename: Mukerrem
authors.initials: M
authors.lastname: Safali
authors.forename: Seyfettin
authors.initials: S
authors.lastname: Ilgan
authors.forename: Sait
authors.initials: S
authors.lastname: Bagci
authors.forename: Kemal
authors.initials: K
authors.lastname: Dagalp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D001729:Bismuth / Q000008:administration & dosage*; D001944:Breath Tests; D017291:Clarithromycin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D011899:Ranitidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013752:Tetracycline / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D008795:Metronidazole; C073340:ranitidine bismuth citrate; D000658:Amoxicillin; D011899:Ranitidine; D013752:Tetracycline; D017291:Clarithromycin; D001729:Bismuth