Cammarota G, Cannizzaro O, Cianci R, Gasbarrini A, Pirozzi G, Gasbarrini G
Department of Internal Medicine and Gastroenterology, Catholic University SC, Rome, Italy.
Hepatogastroenterology. 2000 Jul-Aug;47(34):1176-9.
BACKGROUND/AIMS: Short-term ranitidine bismuth citrate-based triple regimens have been shown to be effective for the eradication of H. pylori. We investigated the efficacy of an eradicating therapy including ranitidine bismuth citrate, low-dose clarithromycin and tinidazole, administered for only 6 days.
Forty-five consecutive patients, who underwent gastroscopy for symptoms and were found to be H. pylori-positive, were recruited. They received ranitidine bismuth citrate 400 mg b.i.d. plus clarithromycin 250 mg b.i.d. plus tinidazole 500 mg b.i.d., given for 6 days. The medications given in twice daily doses were taken after meals with an interval of 12 h. The H. pylori status was evaluated by means of histology and rapid urease test on admission, and by 13C-urea breath test alone 8 weeks after treatment.
All 45 enrolled patients completed the study. Thirty-nine of 45 patients returned H. pylori-negative (both per protocol and intention-to-treat analysis = 87%; 95% confidence interval = from 73-95%), while 6 of 45 were still H. pylori-positive (13%). Slight or mild side effects occurred in 5/45 patients (11%).
Ranitidine bismuth citrate-based triple therapy, containing low-dose clarithromycin and tinidazole, given for only 6 days, yielded high eradication rates with modest side effects. Regimens based on ranitidine bismuth citrate plus two antibiotics at low dosages, administered for less than 7 days, constitute highly promising strategies for eradication of H. pylori.
背景/目的：基于雷尼替丁枸橼酸铋的短期三联疗法已被证明对根除幽门螺杆菌有效。我们研究了一种根除疗法的疗效，该疗法包括雷尼替丁枸橼酸铋、低剂量克拉霉素和替硝唑，仅给药6天。
连续招募了45例因出现症状接受胃镜检查且被发现幽门螺杆菌阳性的患者。他们接受雷尼替丁枸橼酸铋400mg，每日两次，加克拉霉素250mg，每日两次，加替硝唑500mg，每日两次，给药6天。每日两次给药的药物在饭后间隔12小时服用。入院时通过组织学和快速尿素酶试验评估幽门螺杆菌状态，治疗8周后仅通过13C-尿素呼气试验评估。
所有45例入组患者均完成了研究。45例患者中有39例幽门螺杆菌检测呈阴性（按方案分析和意向性分析均为87%；95%置信区间为73%-95%），而45例中有6例仍为幽门螺杆菌阳性（13%）。45例患者中有5例（11%）出现轻微或轻度副作用。
基于雷尼替丁枸橼酸铋的三联疗法，包含低剂量克拉霉素和替硝唑，仅给药6天，根除率高且副作用较小。基于雷尼替丁枸橼酸铋加两种低剂量抗生素、给药少于7天的疗法是根除幽门螺杆菌非常有前景的策略。
