Efficacy of 10-Day and 5-Day Concomitant Therapy for Helicobacter pylori Eradication in Thai Patients With Non Ulcer Dyspepsia

Kongchayanun, Chutima; Mahachai, Varocha; Pornthisarn, Bubpha; Amornsawadwattana, Surachai; Vilaichone, Ratha-Korn

doi:10.1016/s0016-5085(11)63653-6

Cited by 5 publications

(4 citation statements)

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“…A meta-analysis published in 2009 presented the pooled eradication rate of concomitant therapy studies between 1998 to 2002 as 89.7% on ITT and 92.9% on PP analysis [ 20 ]. In recent years, concomitant therapies with duration of 5–10 days are reported 90–96% success rates on PP analysis in Asian countries, including Thailand, Taiwan, and Korea [ 24 , 28 , 29 ]. The high eradication rate (94.5%) was also reported in Europe, such as Greece [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

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

Kao

Chen

Hsu

et al. 2012

Gastroenterology Research and Practice

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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.

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Section: Discussionmentioning

confidence: 99%

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

Kao

Chen

Hsu

et al. 2012

Gastroenterology Research and Practice

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“…The only randomised trial to date that has compared a 5‐day regimen of concomitant therapy with a 10‐day regimen 56 revealed a nonsignificant trend for higher cure rates with the longer regimen (96% with 10 days vs. 90% with 5 days). Although the authors conclude that both durations were “similar”, a type II error may not be ruled out, and this 6% difference may be clinically relevant.…”

Section: Effects Of Different Variables On the Efficacy Of Concomitanmentioning

confidence: 97%

“…Studies evaluating the efficacy of the concomitant regimen are summarised in Table 1 and are represented graphically in Figure 1. 31, 32, 45–57 These studies were performed in different countries in Europe, Asia, and Latin America and most were randomised controlled trials. Similar concomitant regimens were prescribed, with only minor modifications, namely, the PPI (omeprazole, lansoprazole, rabeprazole, or esomeprazole) and the nitroimidazole (metronidazole or tinidazole).…”

Section: Efficacy Of the Concomitant Regimen For Eradication Of H Pymentioning

confidence: 99%

Review article: non-bismuth quadruple (concomitant) therapy for eradication of Helicobater pylori

Gisbert

2011

Alimentary Pharmacology &Amp; Therapeutics

147

104

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Aliment Pharmacol Ther 2011; 34: 604–617 Summary Background Traditional standard triple therapy for Helicobacter pylori infection (PPI‐clarithromycin‐amoxicillin) can easily be converted to non‐bismuth quadruple (concomitant) therapy by the addition of a nitroimidazole twice daily. Aim To critically review evidence on the role of non‐bismuth quadruple therapy (PPI‐clarithromycin‐amoxicillin‐nitroimidazole) in the treatment of H. pylori infection. Methods Bibliographical searches were performed in MEDLINE and relevant congresses. Results The first randomised comparison of the non‐bismuth quadruple therapy and the sequential (PPI‐amoxicillin 5 days plus PPI‐clarithromycin‐nitroimidazole 5 days) regimens recently concluded that both were similar in terms of efficacy and safety and that the sequential administration protocol may be unnecessarily complex. Several randomised controlled trials (and one meta‐analysis) have demonstrated that non‐bismuth quadruple therapy is more effective than and is equally well tolerated as standard triple therapy. A meta‐analysis of 15 studies (1723 patients) revealed a mean H. pylori cure rate (intention‐to‐treat) of 90% for non‐bismuth quadruple therapy. A tendency towards better results with longer treatments (7–10 days vs. 3–5 days) has been observed, so it seems reasonable to recommend the length of treatment by achieving maximal cure rates (10 days). Clarithromycin resistance may reduce the efficacy of non‐bismuth quadruple therapy, although the decrease in eradication rates seems to be far lower than in standard triple therapy. Experience with the non‐bismuth quadruple therapy in patients with metronidazole‐resistant strains is still very limited. Conclusions Non‐bismuth quadruple (concomitant) therapy appears to be an effective, safe, and well‐tolerated alternative to triple therapy and is less complex than sequential therapy. Therefore, this regimen appears well suited for use in settings where the efficacy of triple therapy is unacceptably low.

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“…The main reason for a metallic taste in the mouth can be attributed to the use of metronidazole 14 . Furthermore Aminian et al, in Iran, reported nausea as the most common side effects 20 . In the study of Chan et al, in China in 2001, the most common complications were nausea, vomiting, dizziness and bad taste in the mouth 19 .…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

IJPSR

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There are various treatment regimens including different antibiotics and antacid medications for eradicating Helicobacter pylori to compare the effectiveness of 7-day concomitant regime with classic triple regimen in eradicating H. pylori. In this randomized clinical trial, 206 dyspeptic patients proven H. pylori infection, attended to a gastrointestinal clinic in Khorramabad (west of Iran) were studied. The patients were randomly divided in two equal groups. Classic group were treated for 14 days with a regimen including omeprazole 20mg, amoxicillin 1g and clarithromycin 500mg, twice daily. In concomitant group, the patients were treated for 7 days with a regimen including omeprazole 20mg, amoxicillin 1g, clarithromycin 500mg and metronidazole 500mg twice daily. During the treatment period and a week after the end of treatment, the patients were evaluated in terms of possible side-effects and medication acceptance and tolerance. For confirmation of eradication, 6 weeks after the end of treatment, urea breath test with carbon 13 (UBT) was done for both the groups. Data were analyzed using descriptive statistics, T-test and chi-square test, logistic regression through SPSS software version 21. The level of significance was considered less than 0.05. H. pylori eradication rate in classic group was 68.9% and in concomitant group was 83.4%. (p -value = 0.03). The incidence of gastrointestinal side-effects was not statistically different between the groups. H. pylori eradication rate in 7-day concomitant treatment regimen is more than 14-day classic regimens. Therefore, it is suggested to use 7-day concomitant regimen as first-line of H. pylori eradication.

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Efficacy of 10-Day and 5-Day Concomitant Therapy for Helicobacter pylori Eradication in Thai Patients With Non Ulcer Dyspepsia

Cited by 5 publications

References 0 publications

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

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

Review article: non-bismuth quadruple (concomitant) therapy for eradication of Helicobater pylori

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