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Article: One-week ranitidine bismuth citrate in combinations with metronidazole, amoxycillin and clarithromycin in the treatment of Helicobacter pylori infection: The RBC-MACH study

TitleOne-week ranitidine bismuth citrate in combinations with metronidazole, amoxycillin and clarithromycin in the treatment of Helicobacter pylori infection: The RBC-MACH study
Authors
Issue Date1999
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
Citation
Alimentary Pharmacology And Therapeutics, 1999, v. 13 n. 8, p. 1079-1084 How to Cite?
AbstractBackground: We have previously shown that ranitidine bismuth citrate (RBC)-based triple therapy is comparable to proton pump inhibitor-based triple therapy in eradicating Helicobacter pylori infection. Aim: To test the efficacy of different combinations of antimicrobials with RBC in the treatment of H. pylori infection. Methods: Dyspeptic patients with H. pylori infection were prospectively randomized to receive one of the following regimens: (i) RBC 400 mg, amoxycillin 1 g, clarithromycin 500 mg [RAC]; (ii) RBC 400 mg, metronidazole 400 mg, clarithromycin 500 mg [RMC]; (iii) RBC 400 mg, metronidazole 400 mg, tetracycline 1 g [RMT] (all given twice daily for 1 week); or (iv) RBC 400 mg plus clarithromycin 500 mg twice daily for 2 weeks [RC-2]. Endoscopy (rapid urease test and culture) and 13C-urea breath test (UBT) were performed before randomization. Four weeks after finishing medication, the 13C-UBT was repeated in all cases and endoscopy was offered to patients with peptic ulcers. Results: Four hundred patients were randomized but in two (one in the RAC group and one in the RMC group) H. pylori infection was not confirmed. Successful eradication of H. pylori (intention-to-treat analysis and 95% CI) of RAC (86% [79-93%]), RMC (90% [84-96%]), RMT (74% [71-87%]) and RC-2 (82% [75-90%]) were comparable, with a trend favouring clarithromycin-containing triple therapy regimens. Among 276 isolates tested for antibiotic sensitivity, primary resistance to metronidazole, clarithromycin and amoxycillin was found in 56%, 2% and 0.4%, respectively. When given RMC or RMT, patients infected by metronidazole-resistant H. pylori had success in eradicating H. pylori similar to patients infected by metronidazole-sensitive H. pylori. Conclusion: One-week RBC triple therapy is effective in curing H. pylori infection.
Persistent Identifierhttp://hdl.handle.net/10722/162303
ISSN
2015 Impact Factor: 6.32
2015 SCImago Journal Rankings: 2.833
References

 

DC FieldValueLanguage
dc.contributor.authorSung, JJYen_US
dc.contributor.authorChan, FKLen_US
dc.contributor.authorWu, JCYen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorSuen, Ren_US
dc.contributor.authorLing, TKWen_US
dc.contributor.authorLee, YTen_US
dc.contributor.authorCheng, AFBen_US
dc.contributor.authorSydney Chung, SCen_US
dc.date.accessioned2012-09-05T05:18:46Z-
dc.date.available2012-09-05T05:18:46Z-
dc.date.issued1999en_US
dc.identifier.citationAlimentary Pharmacology And Therapeutics, 1999, v. 13 n. 8, p. 1079-1084en_US
dc.identifier.issn0269-2813en_US
dc.identifier.urihttp://hdl.handle.net/10722/162303-
dc.description.abstractBackground: We have previously shown that ranitidine bismuth citrate (RBC)-based triple therapy is comparable to proton pump inhibitor-based triple therapy in eradicating Helicobacter pylori infection. Aim: To test the efficacy of different combinations of antimicrobials with RBC in the treatment of H. pylori infection. Methods: Dyspeptic patients with H. pylori infection were prospectively randomized to receive one of the following regimens: (i) RBC 400 mg, amoxycillin 1 g, clarithromycin 500 mg [RAC]; (ii) RBC 400 mg, metronidazole 400 mg, clarithromycin 500 mg [RMC]; (iii) RBC 400 mg, metronidazole 400 mg, tetracycline 1 g [RMT] (all given twice daily for 1 week); or (iv) RBC 400 mg plus clarithromycin 500 mg twice daily for 2 weeks [RC-2]. Endoscopy (rapid urease test and culture) and 13C-urea breath test (UBT) were performed before randomization. Four weeks after finishing medication, the 13C-UBT was repeated in all cases and endoscopy was offered to patients with peptic ulcers. Results: Four hundred patients were randomized but in two (one in the RAC group and one in the RMC group) H. pylori infection was not confirmed. Successful eradication of H. pylori (intention-to-treat analysis and 95% CI) of RAC (86% [79-93%]), RMC (90% [84-96%]), RMT (74% [71-87%]) and RC-2 (82% [75-90%]) were comparable, with a trend favouring clarithromycin-containing triple therapy regimens. Among 276 isolates tested for antibiotic sensitivity, primary resistance to metronidazole, clarithromycin and amoxycillin was found in 56%, 2% and 0.4%, respectively. When given RMC or RMT, patients infected by metronidazole-resistant H. pylori had success in eradicating H. pylori similar to patients infected by metronidazole-sensitive H. pylori. Conclusion: One-week RBC triple therapy is effective in curing H. pylori infection.en_US
dc.languageengen_US
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APTen_US
dc.relation.ispartofAlimentary Pharmacology and Therapeuticsen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAmoxicillin - Therapeutic Useen_US
dc.subject.meshAnti-Bacterial Agents - Therapeutic Useen_US
dc.subject.meshAnti-Ulcer Agents - Therapeutic Useen_US
dc.subject.meshBismuth - Therapeutic Useen_US
dc.subject.meshClarithromycin - Therapeutic Useen_US
dc.subject.meshDouble-Blind Methoden_US
dc.subject.meshDrug Combinationsen_US
dc.subject.meshDyspepsia - Drug Therapy - Etiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHelicobacter Infections - Drug Therapy - Microbiologyen_US
dc.subject.meshHelicobacter Pylori - Drug Effectsen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMetronidazole - Therapeutic Useen_US
dc.subject.meshMicrobial Sensitivity Testsen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPenicillins - Therapeutic Useen_US
dc.subject.meshPeptic Ulcer - Drug Therapy - Microbiologyen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRanitidine - Analogs & Derivatives - Therapeutic Useen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleOne-week ranitidine bismuth citrate in combinations with metronidazole, amoxycillin and clarithromycin in the treatment of Helicobacter pylori infection: The RBC-MACH studyen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1365-2036.1999.00580.xen_US
dc.identifier.pmid10468684en_US
dc.identifier.scopuseid_2-s2.0-0032816373en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032816373&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume13en_US
dc.identifier.issue8en_US
dc.identifier.spage1079en_US
dc.identifier.epage1084en_US
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US
dc.identifier.scopusauthoridChan, FKL=7202586434en_US
dc.identifier.scopusauthoridWu, JCY=7409253910en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridSuen, R=18735955900en_US
dc.identifier.scopusauthoridLing, TKW=13310253900en_US
dc.identifier.scopusauthoridLee, YT=35477936800en_US
dc.identifier.scopusauthoridCheng, AFB=7402075035en_US
dc.identifier.scopusauthoridSydney Chung, SC=6602724408en_US

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