2018
DOI: 10.1159/000484981
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Efficacy of Reduced Dosage of Amoxicillin in an Eradication Therapy for Helicobacter pylori Infection in Patients on Hemodialysis: A Randomized Controlled Trial

Abstract: Background: An optimum Helicobacter pylori-eradication regimen for hemodialysis patients is yet to be established because of different pharmacokinetics of amoxicillin involved between hemodialysis patients and healthy subjects. We investigated to establish appropriate doses of amoxicillin for H. pylori infection eradication in hemodialysis patients. Methods: Of 409 hemodialysis patients screened for H. pylori infection, 37 H. pylori-positive patients were randomized to different 1-week eradication regimens: es… Show more

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Cited by 5 publications
(16 citation statements)
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“…Most importantly, amoxicillin is stable under acidic conditions, and HP has higher survival under acidic conditions. Therefore, amoxicillin has a high natural advantage in the eradication of HP [ 20 , 21 ]. HP culture is not in routine clinical testing, and in vitro drug susceptibility testing of HP is not conducted.…”
Section: Discussionmentioning
confidence: 99%
“…Most importantly, amoxicillin is stable under acidic conditions, and HP has higher survival under acidic conditions. Therefore, amoxicillin has a high natural advantage in the eradication of HP [ 20 , 21 ]. HP culture is not in routine clinical testing, and in vitro drug susceptibility testing of HP is not conducted.…”
Section: Discussionmentioning
confidence: 99%
“…Unfortunately, because the prevalence of CAM-resistant H. pylori strains in Japan is increasing (> 30%), the eradication rate is gradually decreasing[ 14 , 50 - 53 ]. Eradication therapy is more challenging in HD patients since they have many exposures to antimicrobial agents due to immune system impairment[ 54 , 55 ]. In fact, 36.4% of patients with chronic renal failure are reported to be infected with CAM-resistant strains, which is significantly higher than in patients with normal renal function (15.2%)[ 54 ].…”
Section: Necessity Of H Pylori Eradication Therapmentioning
confidence: 99%
“…In fact, 36.4% of patients with chronic renal failure are reported to be infected with CAM-resistant strains, which is significantly higher than in patients with normal renal function (15.2%)[ 54 ]. Our recent data published in 2017 shows that rate of CAM-resistant strains in HD patients is 40.5% of infected patients[ 55 ]. Alternative regimens may be designed to use H. pylori- susceptible antimicrobial agents, increased dosages of antimicrobial agents and PPIs, increased dosing frequency, and longer treatment periods, according to international treatment guidelines[ 13 , 52 , 56 - 60 ].…”
Section: Necessity Of H Pylori Eradication Therapmentioning
confidence: 99%
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