Efficacy of Triple Therapy Plus Cetraxate for the Helicobacter pylori Eradication in Partial Gastrectomy Patients

Abstract

In the present study, we aimed to establish an additional standardized protocol with a higher H. pylori eradication rate in the remnant stomach. Fifty-five H. pylori-positive patients were randomly allocated to one of three regimens: LAC--lansoprazole, amoxicillin, and clarithromycin b.i.d. for 7 days (n = 17); LAC+CET--LAC b.i.d. plus cetraxate q.i.d. for 7 days (n = 20); and LEFT--LAC for 7 days in a horizontal body position on the left side for 30 min (n = 18). Patient compliance and side effects were checked via interviews. H. pylori eradication was successful in 75, 72, and 41% in LAC+CET, LEFT, and LAC, respectively. The eradication rate was significantly higher in LAC+CET than in LAC (P = 0.024) but not in LEFT (P = 0.058). Adverse events that occurred in each group were almost all mild ones. Cetraxate plus LAC for 1 week is a safe and effective regime for the eradication of H. pylori in patients after partial gastrectomy.

Physiological evaluation of residual stomach motility after local resection in conscious dogs

“…The ratio 13 CO 2 /CO 2 was measured in each air bag using an infrared spectrophotometer (UBiT-IR300; Otsuka Pharmaceutical), which was the method we used for Helicobacter pylori detection. [15][16][17] …”

Efficacy of a quadruple therapy regimen for Helicobacter pylori eradication after partial gastrectomy

“…However, a standardized protocol for patients with a gastric stump has not been established. Conventional therapy for patients with an intact stomach has been applied to gastric stump patients in most studies ( 11 , 19 , 21 ), but is not as effective as in the general population. This inferior efficacy may be associated with the baseline conditions (age, sex, surgical procedure, disease history) of study populations; the species, dose, treatment course, and drug resistance for PPIs and antibiotics may also be influential factors.…”

“…Simultaneously, the action of PPIs (enteric-coated tablets), which are mainly delivered indirectly, is also impeded ( 28 ). Additional factors that affect direct delivery (forms of drug dose, gastric mucus barrier) and indirect delivery (residual area of the gastric mucosa, gradient of drug concentration, permeability of gastric epithelial cells), as well as extension of lymph node dissection could also influence eradication of H. pylori after gastrectomy ( 19 ). Thus, exploration and establishment of a suitable and effective therapeutic regimen for H. pylori eradication in patients with a residual stomach is important.…”

“…Prevalence of eradication per-protocol (PP) based on omeprazole, lansoprazole, and rabeprazole has been reported to be 42.1-84.6% ( 17 , 18 ), 44-90% ( 11 ,), and 83.1-90.9% ( 23 , 24 ), respectively. With regard to the dosing method, one study showed that triple therapy plus postural change can improve the prevalence of eradication of H. pylori in patients after partial gastrectomy ( 19 ). Possibly because of the availability and safety of bismuth, bismuth-containing quadruple therapy is seldom recommended in H. pylori -positive gastrectomized patients.…”

Role of Helicobacter pylori in gastric cancer following partial gastrectomy for benign ulcer

“…However, this indication is not included in the Spanish consensus conference (25) or other previous meetings, and further studies are needed to confirm the relevant findings in this review. Anyway, and according to a recently published study (33), eradication in gastrectomized patients results in a higher efficacy rate when drugs are taken in a lying position and with the body turned to the left for some 30 minutes.…”