title: Addition of clidinium-C to the 14-day proton-pump inhibitor-based triple therapy for Helicobacter pylori eradication.
abstract: BACKGROUND
  Triple therapy with a proton pump inhibitor and two antibiotics in Helicobacter pylori (HP) eradication is widely accepted, but this combination fails in a considerable number of cases. The aim of this study was to assess the effect of clidinium-C addition on HP eradication and to investigate the efficacy and safety of clidinium-C in prevention of drugs' side effects.
  
  
  METHODS
  A total of 200 histopathologically confirmed HP positive peptic ulcer enrolled in this study which were randomly assigned to two treatment groups: OAC (20 mg omeprazole bid, 1000 mg amoxicillin bid and 500 mg clarithromycin bid) and OAC + clidinium-C. The effect of treatment and adverse effects were compared 6 weeks after completion of treatment. A13C-urea breath test was performed to confirm HP eradication.
  
  
  RESULTS
  A total of 184 patients (90 in group A and 94 in group B) completed the treatment protocols. HP eradication was achieved in 71.1% in OAC versus 72.3% in OCA+clidinium-C, (P=0.73). The frequencies of abdominal pain and stool abnormality, among the side effects recorded during the therapy period, were significantly lower in group B (OCA+clidinium-C) (P=0.01 and P=0.001, respectively).
  
  
  CONCLUSIONS
  Addition of clidinium-C to OCA triple therapy decreases abdominal pain and frequency of stool abnormalities without affecting HP eradication rate. Based on these findings addition of clidinium-C may increase patient's compliance.
authors.affiliation: Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Gorgan, Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Seyyedmajidi
authors.affiliation: Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran.
authors.forename: Saba
authors.initials: S
authors.lastname: Homapoor
authors.affiliation: Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Gorgan, Iran.
authors.forename: Elahe
authors.initials: E
authors.lastname: Zanganeh
authors.affiliation: Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Gorgan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Dadjou
authors.affiliation: Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Gorgan, Iran.
authors.forename: Shahab
authors.initials: S
authors.lastname: Eskandari Nejad
authors.affiliation: Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Gorgan, Iran.
authors.forename: Mohammad Hadi
authors.initials: MH
authors.lastname: Tajik Galayeri
authors.affiliation: Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Vafaeimanesh
keywords: Clidinium-C; Helicobacter pylori eradication; Peptic ulcer; Side effects.