Triple or Quadruple Tetracycline-Based Therapies Versus Standard Triple Treatment for Helicobacter pylori Treatment

• Published in: The American journal of the medical sciences 2009-07, Vol.338 (1), p.50-53
• Main Authors: Songür, Yildiran, Şenol, Altuğ, Balkarli, Ayşe, Baştürk, Abdülkadir, Çerçi, Süreyya
• Format: Article
• Language: English
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles - therapeutic use; Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin - therapeutic use; Anti-Bacterial Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Bismuth; Bismuth - therapeutic use; Clarithromycin - therapeutic use; Drug Therapy, Combination; Eradication; Female; General aspects; Helicobacter Infections - drug therapy; Helicobacter pylori; Helicobacter pylori - metabolism; Human bacterial diseases; Humans; Infectious diseases; Lansoprazole; Male; Medical sciences; Metronidazole - therapeutic use; Middle Aged; Prospective Studies; Tetracyclin; Tetracycline - therapeutic use; Therapy; Treatment Outcome; Young Adult
• ISSN: 0002-9629; 1538-2990
• DOI: 10.1097/MAJ.0b013e31819c7320

Our aim was to compare lansoprazole-tetracycline-metranidazole (LTM) as first-line treatment with the classical lansoprazole-amoxicillin-clarithromycin (LAC) and bismuth-containing quadruple treatments. This prospective, single-center, randomized study included 464 consecutive Helicobacter pylori–positive patients with dyspeptic symptoms. A total of 415 patients completed the study. The patients were allocated into 4 study groups using random sampling numbers as follows—LAC group: lansoprazole 30mg twice daily, amoxicillin 1000mg twice daily, and clarithromycin 500mg twice daily for 14 days; BLTM group: bismuth subcitrate 300mg 4 times a day, lansoprazole 30mg twice daily, tetracycline 500mg 4 times a day, and metronidazole 500mg twice daily for 10days; RBLTM group: ranitidine bismuth citrate 400mg twice daily, lansoprazole 30mg twice daily, tetracycline 500mg 4 times a day, and metronidazole 500mg twice daily for 10 days; and LTM group: lansoprazole 30mg twice daily, tetracycline 500mg 4 times a day, and metronidazole 500mg twice daily for 10 days. The per protocol H. pylori eradication rate in LAC, BLTM, RBLTM, and LTM groups were 37 of 104 (35.6%), 56 of 102 (54.9%), 67 of 104 (64.4%), and 63 of 105 (60%), respectively. The intention–to–treat eradication rate was 37 of 113 (32.7%) in LAC, 56 of 119 (47.1%) in BLTM, 67 of 117 (57.3%) in RBLTM, and 63 of 115 (54.8%) in LTM group. The BLTM, RBLTM, and LTM treatment groups achieved a significantly better eradication rate than the LAC treatment group (P