Published in:
01-01-2015 | Original Article
Ciprofloxacin-containing versus clarithromycin-containing sequential therapy for Helicobacter pylori eradication: A randomized trial
Published in: Indian Journal of Gastroenterology | Issue 1/2015
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Background and Study Aims
Helicobacter pylori eradication rates with standard triple therapy have declined to unacceptable levels. This randomized trial aimed at evaluating the efficacy of a ciprofloxacin containing sequential regimen in the eradication of H. pylori-infected patients vs. a clarithromycin containing sequential therapy.
Methods
A total of 212 patients were randomized into 14-day therapeutic schemes (106 patients per group): (1) clarithromycin-containing sequential therapy rabeprazole plus amoxicillin for 7 days, followed by rabeprazole plus clarithromycin plus metronidazole for 7 days, and (2) ciprofloxacin-containing sequential therapy using ciprofloxacin instead of clarithromycin. Eradication was confirmed by stool H. pylori antigen. Adverse effects and compliance were assessed by a questionnaire.
Results
Per protocol cure rates were as follows: 87.6 % in the ciprofloxacin-containing sequential therapy and 76 % in the clarithromycin group. Intention-to-treat cure rates were as follows: 73.5 % for the ciprofloxacin group and 66 % for the clarithromycin group. No differences in compliance or adverse effects were demonstrated among treatments.
Conclusion
Ciprofloxacin-containing sequential therapy is more effective and equally safe compared to a clarithromycin-containing sequential therapy.