Azithromycin triple therapy for Helicobacter pylori infection: Azithromycin, tetracycline, and bismuth

M. T. Al-Assi, R. M. Genta, T. J. Karttunen, R. A. Cole, D. Y. Graham

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background: Azithromycin is new acid-stable macrolide that achieves 10- to 40-fold higher tissue levels than erythromycin after oral dosing. Important to note, the tissue half-life of azithromycin is measured in days instead of hours. Method: We evaluated two new triple therapies for Helicobacter pylori infection in which azithromycin was substituted for metronidazole either as 250 mg b.i.d. or t.i.d. along with tetracycline 500 mg q.i.d. and bismuth subsalicylate 2 tablets q.i.d. for 14 days. H. pylori status was determined by histology before and 6 wk or more after therapy. Results: Thirty men with documented H. pylori peptic ulcers completed therapy. Twenty-one also received ranitidine (300 mg in the evening) along with the antimicrobial therapy. H. pylori infection was successfully treated in 15 (50%) (95% CI = 31-69%). The cure rate was significantly higher with the 250-mg-t.i.d.- azithromycin dosage regime (83%) (95% CI = 52-98%) compared to the 250-mg- b.i.d.-dosage regime (28%) (95% CI = 10-53%) (p < 0.01). Troublesome side effects were experienced by the majority of those receiving azithromycin t.i.d. Conclusion: We conclude that although 750 mg or more of azithromycin might eventually be able to replace metronidazole or clarithromycin in standard triple therapy, additional studies are required to identify a regime that is both effective and tolerable.

Original languageEnglish (US)
Pages (from-to)403-405
Number of pages3
JournalAmerican Journal of Gastroenterology
Volume90
Issue number3
StatePublished - 1995

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Bismuth
Azithromycin
Helicobacter Infections
Tetracycline
Helicobacter pylori
Metronidazole
Therapeutics
Ranitidine
Clarithromycin
Macrolides
Erythromycin
Peptic Ulcer
Tablets
Half-Life
Histology
Acids

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Al-Assi, M. T., Genta, R. M., Karttunen, T. J., Cole, R. A., & Graham, D. Y. (1995). Azithromycin triple therapy for Helicobacter pylori infection: Azithromycin, tetracycline, and bismuth. American Journal of Gastroenterology, 90(3), 403-405.

Azithromycin triple therapy for Helicobacter pylori infection : Azithromycin, tetracycline, and bismuth. / Al-Assi, M. T.; Genta, R. M.; Karttunen, T. J.; Cole, R. A.; Graham, D. Y.

In: American Journal of Gastroenterology, Vol. 90, No. 3, 1995, p. 403-405.

Research output: Contribution to journalArticle

Al-Assi, MT, Genta, RM, Karttunen, TJ, Cole, RA & Graham, DY 1995, 'Azithromycin triple therapy for Helicobacter pylori infection: Azithromycin, tetracycline, and bismuth', American Journal of Gastroenterology, vol. 90, no. 3, pp. 403-405.
Al-Assi, M. T. ; Genta, R. M. ; Karttunen, T. J. ; Cole, R. A. ; Graham, D. Y. / Azithromycin triple therapy for Helicobacter pylori infection : Azithromycin, tetracycline, and bismuth. In: American Journal of Gastroenterology. 1995 ; Vol. 90, No. 3. pp. 403-405.
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