azithromycin in one week quadruple therapy for h. pylori eradication

background: in developing countries primary antibiotic-resistance and poor compliance are the main causes of helicobacter pylori (hp) eradication failure of standard regimens. aim: to investigate eradication rate, patient's compliance and tolerability of a 1-wk azithromycin based quaruple therapy versus the 2-wk conventional therapy. materials and methods: a total of 129 hp-positive patients were randomized to either omeprazole 20mg, bismuth subcitrate 240 mg, azithromycin 250 mg, metronidazole 500 mg, all twice daily for 1- wk (boazm) or omeprazole 20mg, bismuth subcitrate 240 mg, amoxicillin 1g, metronidazole 500 mg all twice daily for 2-wk (b-oam). hp infection was defined at entry by histology and rapid urease test and cure of infection was determined by negative urea breath test. results: hp eradication rates of b-oazm and b-oam were74.1% and 70.4% respectively at intention to treat and per-protocol analysis 78.1%versus 75.7% respectively. incidence of poor compliance was lower, although not significant, in patients randomized to b-oazm than for b-oam (3.5% versus 4.3 %) but intolerability was similar in two groups ( 35% versus 33.3% ). conclusions: 1-wk azithromycin based quadruple regimen achieves an hp eradication rate comparable to that of standard 2-wk quadruple therapy and is associated with same patient's compliance and complications.