Helicobacter pylori eradication using one‐week low‐dose lansoprazole plus amoxycillin and either clarithromycin or azithromycin

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Abstract
Aim: To evaluate and compare two 1‐week low‐dose triple therapies based on lansoprazole, amoxycillin and a macrolide in eradicating Helicobacter pylori. Methods: Seventy consecutive patients, suffering from dyspeptic symptoms with H. pylori infection, were randomly allocated to one of two treatment groups: (A) (LAC; n=35) lansoprazole 30 mg once daily, amoxycillin 1000 mg b.d., clarithromycin 250 mg b.d., all for 7 days; and (B) (LAA; n=35) lansoprazole 30 mg once daily and amoxycillin 1000 mg b.d., both for 7 days, plus azithromycin 500 mg once daily for only 3 days. The H. pylori status was evaluated by means of histology and rapid urease test at entry and 8 weeks after treatment. Results: Three patients did not complete the treatment: one in the LAC group was withdrawn owing to severe side‐effects; two patients in the LAA group stopped the treatment prematurely. H. pylori eradication was obtained in 28 of 34 (82%; 95% CI=66–93%) patients in the LAC group and in 20 of 33 (61%; 95% CI=42–77%) patients in the LAA group. The difference is significant (PConclusions: Low‐dose lansoprazole plus amoxycillin and clarithromycin is more effective than low‐dose lansoprazole plus amoxycillin and azithromycin, but it gave a greater incidence of side‐effects.

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