7-Day Nonbismuth-Containing Concomitant Therapy Achieves a High Eradication Rate forHelicobacter pyloriin Taiwan

Abstract

Background. Ten-day concomitant therapy achieves a high eradication rate in Taiwan. Whether shortening the duration of concomitant therapy can still keep a high eradication rate remains unclear. Aim. To assess the eradication rate of 7-day pantoprazole-containing concomitant therapy in Taiwan and to investigate factors influencing the eradication outcome. Methods. From March 2008 to March 2012, 319 H. pylori-infected patients receiving a 7-day pantoprazole-containing concomitant regimen (pantoprazole 40 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily for 7 days) were included. Patients were asked to return at the second week to assess drug compliance and adverse effects. Repeated endoscopy or urea breath test was performed at 8 weeks after the end of eradication therapy. Results. The eradication rates according to intention-to-treat and per-protocol analyses were 93.7% (299/319) and 96.4% (297/308), respectively. Adverse events occurred in 13.2% (42/319) of the patients. The compliance rate was 98.4% (314/319). Multivariate analysis disclosed that poor compliance was the only independent factor influencing the efficacy of anti-H. pylori therapy with an odds ratio of 0.073 (95% confidence interval, 0.011–0.483). Conclusion. 7-day concomitant therapy achieved a very high eradication rate for H. pylori infection in Taiwan. Drug compliance was the only clinical factor influencing treatment efficacy.

Reverse Sequential Therapy Achieves a Similar Eradication Rate as Standard Sequential Therapy for Helicobacter pylori Eradication: A Randomized Controlled Trial

“…The promising data presented here are consistent with a head-to-head noninferiority trial of 10-day sequential and 10-day concomitant therapy by our group showing comparable eradication rates (93.0% vs 93.1%) for H. pylori eradication [24]. Concomitant therapy is a four-drug regimen containing a PPI [30]. This therapy is superior to standard triple therapy for H. pylori eradication [31].…”

“…), and metronidazole (500 mg, b.i.d.) which are all given for the entire duration of therapy . This therapy is superior to standard triple therapy for H. pylori eradication .…”

Challenging the dogma: a randomized trial of standard vs. half‐dose concomitant nonbismuth quadruple therapy for Helicobacter pylori infection

“…11 More recently, multiple trials of concomitant NBQT have confirmed an ITT eradication rate of 75-96.4% (per-protocol rates consistently superior to 80%) with a possible advantage for longer treatment duration (Table 3). 15,16,[21][22][23][24][25][26][27][28][29][30][31][32] The results of this randomized trial appear to confirm our earlier observation 13 that reduced-dose regimens (down to 50% posology) performs similarly to standard-dose regimens with the added benefit of reduced cost and adverse events. To date, three randomized controlled trials, involving a total of 475 patients, have examined the value of 50% reduction in the dose of all administered antibiotics for H. pylori (two STT and the current concomitant NBQT) and have all confirmed similar eradication rates to the standard-dose comparator (Table 4), with a reduction in adverse events and cost.…”

Review: Clinical Management of Helicobacter pylori Infection in China

“…In Taiwan, Kao SS et al. reported that 7 days of a concomitant regimen (pantoprazole 40 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily for 7 days) achieved a high H. pylori eradication rate (93.7% by ITT and 96.4% by PP). Wu et al.…”

“…In Taiwan, Kao SS et al reported that 7 days of a concomitant regimen (pantoprazole 40 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily for 7 days) achieved a high H. pylori eradication rate (93.7% by ITT and 96.4% by PP) [66]. Wu et al [67] obtained similar results in another study, the ITT eradication rate reached 93.0% after concomitant therapy, and the authors concluded that concomitant therapy may be more suitable for patients with dual resistance to antibiotics.…”