title: Replacement of clarithromycin with azithromycin in triple therapy regimens for the eradication of Helicobacter pylori: A randomized clinical trial.
abstract: BACKGROUND
  Eradication of helicobacter pylori is important for treatment of GU but an ideal regimen is not available. HP is resistant to metronidazole and clarithromycin. Clarithromycin is expensive and is not available in under developing countries. This study aimed to compare two regimens containing clarithromycin or azithromycin.
  
  
  METHODS
  Totally, seventy-eight patients with GU (confirmed with endoscopy) and infection of HP (Confirmed by Rapid Urease Test (RUT)) were allocated to one of the groups of study (35 participants in each group). Two weeks regimen of Clarithromycin (2×500 mg) + Amoxicillin (2×1 gr) + omeprazole (2×20 mg) was administered for group A of patients while group B got a 10 days regimen of Azithromycin (1×250 mg) + 14 days Amoxicillin (2×1 gr) + omeprazole (2×20 mg). At the end of the treatment course, the patients were evaluated according to the side effects of the drugs. In addition, two months after the end of therapy, patients underwent endoscopy and biopsy to evaluate HP eradication.
  
  
  RESULTS
  After two weeks, the side effects of the drug were: Nausea 8 patients in group A and 7 patients in group B, Diarrhea 2 patients in group A, 3 patients in group B and vomiting 2 patients in group A, 3 patients in group B. There were no serious side effects in any group. Eradication rate in group A was 82.9% (based on per protocol analysis (PPA)) and 84.6 % (intention to treat (ITT)). In group B, eradication rate was 77.1 % (PPA) and 79.5 % (ITT) (P=0.55).
  
  
  CONCLUSIONS
  Based on our study results, azithromycin can be used in HP eradication regimen because of its similar efficacy to clarithromycin but also have lower cost, side effects and resistance.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Khoshnood
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: P
authors.initials: P
authors.lastname: Hakimi
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: H
authors.initials: H
authors.lastname: Salman-Roghani
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Reza Mirjalili
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D017963:Azithromycin / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D017291:Clarithromycin / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D007492:Iran; D008297:Male; D009853:Omeprazole / Q000627:therapeutic use; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000382:microbiology*
chemical_list: D000658:Amoxicillin; D017963:Azithromycin; D017291:Clarithromycin; D009853:Omeprazole
keywords: Azithromycin; Clarithromycin; Eradication; Helicobacter Pylori