• Veldhuyzen van ZantenSanderSDalhousie University, Department of Medicine, Halifax, Nova Scotia, Canada. Zanten@dal.ca, Naoki Chiba, Alan Barkun, Carlo Fallone, Alain Farley, Alan Cockeram, Chrystian Dallaire, Lorinda Simms, and Barbara Nicholls.
• Dalhousie University, Department of Medicine, Halifax, Nova Scotia, Canada. Zanten@dal.ca
• Can. J. Gastroenterol. 2003 Sep 1; 17 (9): 533-8.

ObjectiveTo assess Helicobacter pylori eradication after one week dual ranitidine bismuth citrate-clarithromycin (RBC-C) or triple omeprazole, clarithromycin and amoxicillin (OCA) therapy.MethodsIn this multicentre Canadian trial, H pylori-positive patients with functional dyspepsia or inactive peptic ulcer disease were randomized to open-label treatment with RBC-C (ranitidine bismuth citrate 400 mg plus clarithromycin 500 mg) or OCA (omezaprole 20 mg, clarithromycin 500 mg and amoxicillin 1000 mg), given twice a day for seven days. Treatment allocation was randomly assigned. H pylori infection was confirmed by positive 13C-urea breath test (13C-UBT). H pylori status was reassessed by UBT at least four and 12 weeks after treatment (negative: d13CO2 below 3.5 per mil). Intention-to-treat (ITT) eradication rates were determined for all patients with confirmed H pylori infection. Per protocol (PP) rate was determined for all patients treated with at least two evaluable follow-up visits.ResultsThree hundred five patients were included in the ITT and 222 in the PP analysis. The ITT eradication rates were 66% for RBC-C and 78% for OCA. The PP success rates were 84% for RBC-C and 96% for OCA. The difference for both ITT 12% (95% CI 2 to 22) and PP 12% (95% CI 4 to 19) were statistically significant, P=0.030 and P=0.007, respectively. Treatment was generally well tolerated.ConclusionThe eradication rate for the seven-day dual RBC-C regimen was lower than that for OCA.

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