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Abstract
Background: Eradication of helicobacter pylori is important for treatment of GU but an ideal regimen is not available. HP is resistant to metronidazole and clarithromycin. Clarithromycin is expensive and is not available in under developing countries. This study aimed to compare two regimens containing clarithromycin or azithromycin.
Methods: Totally, seventy-eight patients with GU (confirmed with endoscopy) and infection of HP (Confirmed by Rapid Urease Test (RUT)) were allocated to one of the groups of study (35 participants in each group). Two weeks regimen of Clarithromycin (2x500 mg) + Amoxicillin (2x1 gr) + omeprazole (2x20 mg) was administered for group A of patients while group B got a 10 days regimen of Azithromycin (1x250 mg) + 14 days Amoxicillin (2x1 gr) + omeprazole (2x20 mg). At the end of the treatment course, the patients were evaluated according to the side effects of the drugs. In addition, two months after the end of therapy, patients underwent endoscopy and biopsy to evaluate HP eradication.
Results: After two weeks, the side effects of the drug were: Nausea 8 patients in group A and 7 patients in group B, Diarrhea 2 patients in group A, 3 patients in group B and vomiting 2 patients in group A, 3 patients in group B. There were no serious side effects in any group. Eradication rate in group A was 82.9% (based on per protocol analysis (PPA)) and 84.6 % (intention to treat (ITT)). In group B, eradication rate was 77.1 % (PPA) and 79.5 % (ITT) (P=0.55).
Conclusion: Based on our study results, azithromycin can be used in HP eradication regimen because of its similar efficacy to clarithromycin but also have lower cost, side effects and resistance.
Keywords: Helicobacter Pylori, Eradication, Azithromycin, Clarithromycin
Introduction
Helicobacter pylori infection is one of the most prevalent gastro intestinal infections worldwide but its prevalence in different countries and population is different, it also has a direct relationship with low socioeconomic situation [1-4]. In developed societies, the prevalence is about 20%-50% while in developing countries about 80% of adults are infected [5]. In Iran reports show that 70.1% of people with gastritis, 86.2% of duodenal ulcer patients and 70% of gastric ulcer patients are infected with helicobacter pylori that will increase by age [6,7]....