Comparison of azithromycin and metronidazole in a quadruple-therapy regimen for Helicobacter pylori eradication in dyspepsia

Saudi J Gastroenterol. 2009 Oct-Dec;15(4):225-8. doi: 10.4103/1319-3767.56091.

Abstract

Background/aim: Helicobacter pylori (H pylori) plays an important role in the pathogenesis of chronic gastritis, peptic ulcer disease, and gastric neoplasms . Therefore, it is necessary to select an effective regimen for H pylori eradication . The aim of this study was to compare the efficacy of two quadruple-therapy regimens-one with azithromycin and the other with metronidazole-for H pylori eradication in patients with dyspepsia.

Materials and methods: In this double-blind randomized clinical trial conducted in Rasoule-Akram Hospital in 2006, we included 60 patients (aged 15-70 years) who had dyspepsia and H pylori infection as diagnosed by upper gastrointestinal endoscopy and rapid urease test. Patients were randomly assigned to receive a quadruple-therapy regimen for 2 weeks: 1) the MAO-B group (n = 30) received metronidazole 500 mg b.i.d, amoxicillin 1g b.i.d, omeprazole 20 mg b.i.d, and bismuth 240 mg b.i.d and 2) the AAO-B group (n = 30) received azithromycin 500 mg once daily for 1 week and amoxicillin 1g b.i.d, omeprazole 20 mg b.i.d, and bismuth 240 mg b.i.d for 2 weeks). H pylori eradication was assessed by the rapid urease test (RUT) 2 months after the cessation of treatment .

Results: H pylori was eradicated in 68% and 69% of patients in the MAO-B and AAO-B groups, respectively. There was no significant difference in H pylori eradication rates between the two groups (P = 0.939).

Conclusion: No significant difference exists between the two quadruple-therapy regimens that were tested.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amoxicillin / administration & dosage
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Ulcer Agents / administration & dosage
  • Azithromycin / administration & dosage*
  • Bismuth / administration & dosage
  • Double-Blind Method
  • Drug Therapy, Combination
  • Dyspepsia / drug therapy*
  • Dyspepsia / microbiology
  • Female
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori / drug effects
  • Humans
  • Male
  • Metronidazole / administration & dosage*
  • Middle Aged
  • Omeprazole / administration & dosage
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anti-Ulcer Agents
  • Metronidazole
  • Amoxicillin
  • Azithromycin
  • Omeprazole
  • Bismuth