Riff D S, Kidd S, Rose P, Haber M, Weissfeld A, Siepman N
Associated Gastroenterology Medical Group, Anaheim, CA 92801, USA.
Helicobacter. 1996 Dec;1(4):238-42. doi: 10.1111/j.1523-5378.1996.tb00045.x.
Given the therapeutic potential of proton pump inhibitor-based triple therapy for successful cure of Helicobacter pylori infection, we evaluated the efficacy and safety of lansoprazole with clarithromycin and amoxicillin in an open-label, single-center study.
H. pylori-positive patients self-administered lansoprazole, 30 mg; clarithromycin, 500 mg; and amoxicillin, 1 gm bid for 14 days. Patients were assessed pretreatment, at which time the presence of H. pylori was documented by rapid urease test, culture, or histology, following study drug administration (week 2) for a brief evaluation only, and at least 4 weeks posttreatment (week 6), which included endoscopy with collection of biopsy specimens for culture and histology testing.
Primary clarithromycin and metronidazole resistance were observed in 6% (2 of 30) and 43% (13 of 30) of study patients, respectively. One month after the end of therapy, H. pylori infection was cured in 23 of 25 patients (92%; 95% confidence interval, 74%-99%). The triple-therapy regimen was well-tolerated; 17% of patients (5 of 30) reported mild to moderate adverse effects during the treatment period.
A 2-week, triple-drug combination of lansoprazole, clarithoromycin, and amoxicillin is highly effective for cure of H. pylori infection. Additionally, the triple-drug combination was well-tolerated by patients infected with H. pylori.
鉴于基于质子泵抑制剂的三联疗法在成功治愈幽门螺杆菌感染方面的治疗潜力，我们在一项开放标签的单中心研究中评估了兰索拉唑联合克拉霉素和阿莫西林的疗效及安全性。
幽门螺杆菌阳性患者自行服用兰索拉唑30毫克、克拉霉素500毫克和阿莫西林1克，每日两次，共14天。在治疗前对患者进行评估，此时通过快速尿素酶试验、培养或组织学检查记录幽门螺杆菌的存在情况；在研究药物给药后（第2周）仅进行简要评估；在治疗后至少4周（第6周）进行评估，包括内镜检查并采集活检标本进行培养和组织学检测。
在研究患者中，分别观察到原发性克拉霉素和甲硝唑耐药率为6%（30例中的2例）和43%（30例中的13例）。治疗结束后1个月，25例患者中有23例（92%；95%置信区间为74%-99%）幽门螺杆菌感染得到治愈。三联疗法耐受性良好；17%的患者（30例中的5例）在治疗期间报告有轻度至中度不良反应。
兰索拉唑、克拉霉素和阿莫西林的两周三联药物组合对治愈幽门螺杆菌感染非常有效。此外，幽门螺杆菌感染患者对该三联药物组合耐受性良好。
