Clarithromycin as monotherapy for eradication of Helicobacter pylori: A randomized, double-blind trial

W. L. Peterson, D. Y. Graham, B. Marshall, M. J. Blaser, R. M. Genta, P. D. Klein, C. W. Stratton, J. Drnec, P. Prokocimer, N. Siepman

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226 Scopus citations


Current regimens to eradicate Helicobacter pylori usually consist of metronidazole plus a bismuth compound, as well as a third agent such as tetracycline. Such regimens are not ideal because organisms may be metronidazole-resistant, side-effects occur, and compliance is often poor. This randomized, double-blind study was designed to assess the ability of clarithromycin, a new macrolide antimicrobial, as monotherapy to eradicate H. pylori. Thirty-seven healthy volunteers who were H. pylori positive by 13C- urea breath test plus histology and/or culture completed 14 days of oral therapy with clarithromycin in one of three dosages. Eradication, defined as all three tests negative at 4-6 wk after the end of therapy, was achieved in 2/13 (15%) with clarithromycin 500 mg bid, 4/11 (36%) with 1000 mg bid, and 7/13 (54%) with 500 mg qid. Isolates of H. pylori were resistant to clarithromycin prior to therapy in 12% of subjects, and became resistant during therapy in 21% of subjects. Taste perversion, the most common side effect, resulted in one subject terminating therapy. Conclusions: Whereas clarithromycin is a promising antimicrobial in the eradication of H. pylori, it is not sufficient to be used as monotherapy.

Original languageEnglish (US)
Pages (from-to)1860-1864
Number of pages5
JournalAmerican Journal of Gastroenterology
Issue number11
StatePublished - Jan 1 1993

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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