Addition of clidinium-C to the 14-day proton-pump inhibitor-based triple therapy for Helicobacter pylori eradication

Background: triple therapy with a proton pump inhibitor and two antibiotics in helicobacter pylori (hp) eradication is widely accepted,but this combination fails in a considerable number of cases. the aim of this study was to assess the effect of clidinium-c addition on hp eradication and to investigate the efficacy and safety of clidinium-c in prevention of drugs' side effects. methods: a total of 200 histopathologically confirmed hp positive peptic ulcer enrolled in this study which were randomly assigned to two treatment groups: oac (20 mg omeprazole bid,1000 mg amoxicillin bid and 500 mg clarithromycin bid) and oac + clidinium-c. the effect of treatment and adverse effects were compared 6 weeks after completion of treatment. a13c-urea breath test was performed to confirm hp eradication. results: a total of 184 patients (90 in group a and 94 in group b) completed the treatment protocols. hp eradication was achieved in 71.1% in oac versus 72.3% in oca+clidinium-c,(p=0.73). the frequencies of abdominal pain and stool abnormality,among the side effects recorded during the therapy period,were significantly lower in group b (oca+clidinium-c) (p=0.01 and p=0.001,respectively). conclusion: addition of clidinium-c to oca triple therapy decreases abdominal pain and frequency of stool abnormalities without affecting hp eradication rate. based on these findings addition of clidinium-c may increase patient's compliance.