Clarithromycin sustained-release tablet may be an improper therapy for the eradication of .

BACKGROUND

Clarithromycin plays an important role in eradicating () through quadruple therapy. However, there is limited research on whether different forms of clarithromycin dosage have similar efficacies against

OBJECTIVE

We aimed to evaluate the efficacy of different forms of clarithromycin dosage in bismuth-containing quadruple therapy for eradicating

DESIGN

A single-center retrospective analysis comparing the efficacy of different forms of clarithromycin dosage in eradicating

METHODS

An analysis was conducted on patients diagnosed with infection through the C-urea breath test (13C-UBT) at Henan Provincial People's Hospital, China from 2020 to 2022 who were treated with either a dispersible or sustained-release clarithromycin tablet (500 mg each), alongside amoxicillin (1000 mg), a standard dose of proton pump inhibitors (PPIs), and bismuth citrate (220 mg), administered twice daily as part of bismuth-containing quadruple therapy. Treatment efficacy was assessed using 13C-UBT at least 4 weeks after treatment completion. The eradication rate was the primary outcome of this study, and factors influencing it were analyzed.

RESULTS

Among 2094 screened patients, 307 with infection (mean age, 41.8 ± 0.7 years; 43% men) received bismuth-containing quadruple therapy. Univariate analysis of the dispersible and sustained-release tablet groups revealed a lower eradication rate with the sustained-release tablet compared with the dispersible clarithromycin tablet regimen (75.26% (73/97) vs 95.26% (200/210), respectively;  < 0.05). Other factors, such as smoking, age, and PPI type, were not significantly associated with the cure rate. Multivariate analysis identified the form of clarithromycin dosage (dispersible vs sustained-release) to be an independent risk factor for eradication failure using the bismuth-containing quadruple therapy (odds ratio = 0.145, 95% confidence interval: (0.065-0.323);  < 0.05).

CONCLUSION

The clarithromycin dispersible tablet demonstrated a higher eradication rate, and the sustained-release clarithromycin tablet may be inappropriate for eradication.