The Efficacy of Ranitidine Bismuth Citrate, Clarithromycin, Amoxicillin for Eradication of Helicobacter Pylori with Peptic Ulcer Disease

Helicobacter pylori(H. pylori) infection causes an active chronic gastritis and is an important etiological factor in developement of peptic ulcers. Successful treatment of this infection heals ulcers and reduces the risk of peptic ulcer relapse. We performed this study to assess the safety, tolerance and efficacy of a one week course of triple therapy with twice daily dosing using ranitidine bismuth citrate(RBC) with clarithromycin and amoxicillin for eradication of H. pylori.

H. pylori positive thirty-five patient(mean age 51.7±15.8 years, range : 16-74 years, Male : Female=27 : 9) with active peptic ulcer were enrolled in study. H. pylori infection was detected by CLO-test or histology, both antral and corpus biopsies. Patients were treated for 7 days with combination of RBC 400mg bid, clarithromycin 500mg bid, amoxicillin 1g bid. Eradication was defined as no evidence of H. pylori infection by Urea breath test performed at 4-6 weeks after the completion of therapy. Adverse events and compliance were assessed.

Twenty six out of 35 subjects completed the study. Patient's sex, age, smoking status, alcohol consumption, or history of ulcer had no significant effect on eradication of H. pylori. The per protocol and intention-to-treat eradication rate was 88.5%(23/26) and 65.7% (23/35), respectively. The per protocol eradication rate was 100%(10/10) for duodenal ulcer, 92.3%(12/13) for gastric ulcer, and 33.4%(1/3) for gastric and duodenal ulcer, respectively. Three patients experienced side effects during therapy, none that were considered severe.

Ranitidine bismuth citrate in combination with clarithromycin and amoxicillin in a one week b.i.d dosing regimen is well tolerated and effective in eradicating H. pylori infection.