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Comparison of the efficacy of 250 mg and 500 mg clarithromycin used with lansoprazole and amoxicillin in eradication regimens forHelicobacter pylori infection

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Summary

Aims and methods

The aim of this study was to compare the efficacy of 250 mg and 500 mg clarithromycin used with lansoprazole and amoxicillin in eradication ofH. pylori infection, 235 patients withH. pylori infections and non-ulcer dyspepsia were randomly assigned to one of the following regimens: lansoprazole 30 mg, amoxicillin 1000 mg, clarithromycin 250 mg (LAC250) and lansoprazole 30 mg, amoxicillin 1000 mg, clarithromycin 500 mg (LAC500). All drugs were given twice daily for 7 days. The patients were assessed for prevalence ofH. pylori with the CLO test. Gastric biopsy samples obtained during upper gastrointestinal endoscopy before randomization and 4–6 weeks after completion of therapy were used for histology and culture. Bacterial sensitivity to clarithromycin and amoxicillin was determined with the E-test.

Results

101 patients in the LAC250 mg group and 102 in the LAC500 group completed the study. On intention-to-treat analysis, eradication rates were 81% with LAC250 and 82% with LAC500 (p=0,88). On per-protocol analysis, eradication rates were 92% with LAC250 and 96% with LAC500 (p=0.23).

Among the 203 patients (86% of the entire study group) for whomH. pylori antibiotic-sensitivity testing was technically feasible, primary resistance to clarithromycin was found in 9% and to amoxicillin in 0%. Eradication of clarithromycin sencitive/resistant strains was 94%/38% for LAC250 (p<0.001) and 93%/40% for LAC500 (p< 0.001)

Conclusions

The cure rates for the two regimens were similar, although adverse effects were more frequent with the LAC500 regimen, suggesting that 250 mg of clarithromycin b. d. may be sufficient in our patient population.

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Authors and Affiliations

  1. Department of Hepatogastroenterology Internal Medicine Clinic, General Hospital “Sveti Duh”, Sveti Duh 64, Zagreb, Croatia

    Josip Bago M.D., Ph.D., Anita Galović, Željka Belošié Halle & A. Bilić

  2. Department of Internal Medicine, University Hospital “Mostar”, Mostar, Bosnia and Herzegovina

    M. Bevanda

  3. School of Medicine, University of Zagreb, Croatia

    Petra Bago (Student)

Authors
  1. Josip Bago M.D., Ph.D.
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  2. Anita Galović
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  3. Željka Belošié Halle
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  4. A. Bilić
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  5. M. Bevanda
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  6. Petra Bago
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Correspondence to Josip Bago M.D., Ph.D..

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Bago, J., Galović, A., Belošié Halle, Ž. et al. Comparison of the efficacy of 250 mg and 500 mg clarithromycin used with lansoprazole and amoxicillin in eradication regimens forHelicobacter pylori infection. Wien Klin Wochenschr 116, 495–499 (2004). https://doi.org/10.1007/BF03040946

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  • DOI: https://doi.org/10.1007/BF03040946

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