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Clarithromycin Versus Metronidazole as First-line Helicobacter pylori Eradication: A Multicenter, Prospective, Randomized Controlled Study in Japan.
T. Nishizawa, T. Maekawa, N. Watanabe, N. Harada, Y. Hosoda, M. Yoshinaga, T. Yoshio, H. Ohta, S. Inoue, T. Toyokawa, H. Yamashita, H. Saito, T. Kuwai, S. Katayama, E. Masuda, H. Miyabayashi, T. Kimura, Y. Nishizawa, M. Takahashi, H. Suzuki
J. Clin. Gastroenterol. 2015 Jul;49(6):468-71.
PubMed: 24921211
Abstract
Helicobacter pylori eradication rates achieved with a first-line regimen of clarithromycin (CLR) combined with amoxicillin (AMX) and a proton pump inhibitor have recently fallen to ≤80% because of the increasing incidence of CLR resistance in Japan. This randomized multicenter trial aimed to compare the eradication success of 2 first-line triple therapy regimens: rabeprazole, amoxicillin, and clarithromycin (RAC) versus rabeprazole, amoxicillin, and metronidazole (RAM). A total of 124 consecutive patients infected with H. pylori were randomized into one of two 7-day therapeutic regimens: RAC (n=60) or RAM (n=64). Eradication was confirmed by the C-urea breath test. Adverse effects were also assessed. Intention-to-treat and per protocol H. pylori eradication rates were 73.3%/77.2% in the RAC group and 90.6%/93.5% in the RAM group. The eradication rate of RAM therapy was significantly higher than that of RAC therapy. CLR, metronidazole, and AMX resistance was found in 36.2%, 2.1%, and 0% of patients, respectively. In addition, no relevant differences in adverse effects were observed. Metronidazole-based therapy (RAM) was superior to standard CLR-based therapy (RAC) for first-line H. pylori eradication. This reflects the progressive increase in CLR resistance observed in Japan.
Associated compounds:
Compound Name
with link to compound page |
Structure | Number of references |
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Urea | 1130 |