One-week regimens containing ranitidine bismuth citrate, furazolidone and either amoxicillin or tetracycline effectively eradicate Helicobacter pylori: a multicentre, randomized, double-blind study

BACKGROUND: The metronidazole resistance of Helicobacter pylori strains has increased rapidly. AIM: To evaluate the efficacy and safety of new 1-week regimens containing ranitidine bismuth citrate, furazolidone and either amoxicillin or tetracycline. METHODS: One hundred and twenty patients with H. pylori-positive inactive duodenal ulcer or non-ulcer dyspepsia diagnosed by endoscopy were recruited randomly to receive one of two regimens for 7 days: ranitidine bismuth citrate, 350 mg b.d., furazolidone, 100 mg b.d., and either amoxicillin, 1000 mg b.d. (n=60), or tetracycline, 500 mg b.d. (n=60). H. pylori infection was identified by rapid urease testing and histology. 13C-Urea breath test was performed to evaluate the cure of H. pylori infection at least 4 weeks after completion of triple therapy. RESULTS: The eradication rates of H. pylori by ranitidine bismuth citrate-furazolidone-amoxicillin and ranitidine bismuth citrate-furazolidone-tetracycline regimens were 82% and 85% (P > 0.05), respectively, by intention-to-treat analysis, and 85% and 91% (P > 0.05), respectively, by per protocol analysis. Adverse effects were mild in both ranitidine bismuth citrate-furazolidone-amoxicillin and ranitidine bismuth citrate-furazolidone-tetracycline groups. CONCLUSIONS: One-week regimens containing ranitidine bismuth citrate, furazolidone and amoxicillin or tetracycline are well tolerated and effective for the eradication of H. pylori.