title: Ciprofloxacin-containing versus clarithromycin-containing sequential therapy for Helicobacter pylori eradication: A randomized trial.
abstract: OBJECTIVE
  Helicobacter pylori eradication rates with standard triple therapy have declined to unacceptable levels. This randomized trial aimed at evaluating the efficacy of a ciprofloxacin containing sequential regimen in the eradication of H. pylori-infected patients vs. a clarithromycin containing sequential therapy.
  
  
  METHODS
  A total of 212 patients were randomized into 14-day therapeutic schemes (106 patients per group): (1) clarithromycin-containing sequential therapy rabeprazole plus amoxicillin for 7 days, followed by rabeprazole plus clarithromycin plus metronidazole for 7 days, and (2) ciprofloxacin-containing sequential therapy using ciprofloxacin instead of clarithromycin. Eradication was confirmed by stool H. pylori antigen. Adverse effects and compliance were assessed by a questionnaire.
  
  
  RESULTS
  Per protocol cure rates were as follows: 87.6 % in the ciprofloxacin-containing sequential therapy and 76 % in the clarithromycin group. Intention-to-treat cure rates were as follows: 73.5 % for the ciprofloxacin group and 66 % for the clarithromycin group. No differences in compliance or adverse effects were demonstrated among treatments.
  
  
  CONCLUSIONS
  Ciprofloxacin-containing sequential therapy is more effective and equally safe compared to a clarithromycin-containing sequential therapy.
authors.affiliation: Hepatogastroenterology Clinic, Qatar Armed Forces, Dohar, Qatar, nabilca@yahoo.fr.
authors.forename: Nabil
authors.initials: N
authors.lastname: Ben Chaabane
authors.forename: Hamad Saadoon
authors.initials: HS
authors.lastname: Al-Adhba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D002939:Ciprofloxacin / Q000008:administration & dosage*; D017291:Clarithromycin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005756:Gastritis / Q000188:drug therapy* / Q000382:microbiology*; D016481:Helicobacter Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D064750:Rabeprazole / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008795:Metronidazole; D064750:Rabeprazole; D002939:Ciprofloxacin; D000658:Amoxicillin; D017291:Clarithromycin