Low <i>Helicobacter pylori</i> eradication rates with 4‐ and 7‐day regimens in an Iranian population

Malekzadeh, Reza; Merat, Shahin; Derakhshan, Mohammad H.; Siavoshi, Farideh; Yazdanbod, Abbas; Mikaeli, Javad; Sotoudemanesh, Rasoul; Sotoudeh, Masoud; Farahvash, M J; Nasseri‐Moghaddam, Siavosh; Pourshams, Akram; Dolatshahi, Shahab; Abedi, Behnoosh; Babaei, Mohammad; Arshi, Shahnam; Majidpour, Ali

doi:10.1046/j.1440-1746.2003.02897.x

Cited by 32 publications

(44 citation statements)

References 29 publications

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“…one to five days) have demonstrated eradication rates of 89% to 95%, and has increased patient compliance potential (28,29). Nevertheless, in the USA and most of the developing countries short course therapy has seen suboptimal results (10,11,14). The azilide antibiotic, azithromycin, is acid stable and has a very good in vitro activity against H. pylori.…”

Section: Discussionmentioning

confidence: 99%

“…Antibiotic resistance due to wide spread injudicious drug use, racial differences, social and other factors related to drug compliance and also many other local variables may be causative factors. In contradiction with European and Brazilian (13) studies, it appears that treatment should be given for more than 7 days in other countries including Iran and USA (10,11,14). The issue of cost further complicates the choice of therapy, especially in underdeveloped countries.…”

Section: Introductionmentioning

confidence: 91%

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Azithromycin based triple therapy versus standard clarithromycin based triple therapy in eradication of Helicobacter pylori infection in Iran: a randomized controlled clinical trial

Sarkeshikian¹,

Iranikhah²,

Ghadir³

2009

Turk J Gastroenterol

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clarithromycin, amoxicillin, and omeprazole and azithromycin, amoxicillin, and omeprazole, respectively, and completed the study course. Per protocol, eradication rate was 83% with clarithromycin, amoxicillin, and omeprazole and 75% with azithromycin, amoxicillin, and omeprazole (p =0.158). Eradication rate for a subgroup of patients with peptic ulcer disease in two groups were 83% and 74%, respectively (p=0.134

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Azithromycin based triple therapy versus standard clarithromycin based triple therapy in eradication of Helicobacter pylori infection in Iran: a randomized controlled clinical trial

Sarkeshikian¹,

Iranikhah²,

Ghadir³

2009

Turk J Gastroenterol

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“…We opted to prescribe antibiotics for ten days because 4-and 7-d regimens have been unsuccessful in Iran [9] . In this study, the eradication rates for the triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies were not significantly different.…”

Section: Discussionmentioning

confidence: 99%

“…The metronidazole-based standard triple therapy regimen has been unsuccessful in H pylori eradication, yielding an eradication rate of only about 55% compared with about 90% in other countries [13,14] . This is because metronidazoleresistant H pylori strains are rather common in Iran as well as in other developing countries [9,15] . The high prevalence of metronidazole-resistance in Iran could be explained by the frequent use of metronidazole to treat various infections, thereby promoting antibiotic resistance in H pylori.…”

Section: Discussionmentioning

confidence: 99%

Triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies for H pylori eradication: A comparative three-armed randomized clinical trial

Seyed¹,

Amir²,

Mirbagheri³

et al. 2006

WJG

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AIM:To compare the effectiveness of triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies for H pylori eradication in a comparative threearmed randomized clinical trial. METHODS:A total of 360 H pylori -positive patients suffering from dyspepsia and aging 24-79 years with a median age of 42 years were enrolled in the study and randomly allocated into the following three groups: group A (n = 120) received a standard 1-wk triple therapy ( Chi-square test with the consideration of P < 0.05 as significant was used to compare the eradication rates by intention-to-treat and per-protocol analyses in the three groups. RESULTS:The per-protocol eradication rate was 91.81% (101 patients from a total of 110) in group A, 85.84% (97 patients from a total of 113) in group B, and 92.85% (104 patients from a total of 112) in group C. The intentionto-treat eradication rate was 84.17% in group A, 80.83% in group B, and 86.67% in group C. The new protocol yielded the highest eradication rates by both per-protocol and intention-to-treat analyses followed by the standard triple and quadruple regimens, respectively. However, the differences were not statistically significant between the three groups. CONCLUSION:The results of this study provide further support for the equivalence of triple and quadruple therapies in terms of effectiveness, compliance and sideeffect profile when administered as first-line treatment for H pylori infection. Moreover, the new protocol using ampicillin-sulbactam instead of amoxicillin in the quadruple regimen is a suitable first-line alternative to be

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“…Out of three 7-d regimens, 1 study showed acceptable eradication rates [19][20][21] . Also, out of three 10-d regimens, 2 were successful in achieving > 90% PP eradication rate [22][23][24] and out of three 14-d regimens, 1 yielded optimal results [25][26][27] .…”

Section: Standard Triple Therapymentioning

confidence: 99%

Helicobacter pylorieradication in West Asia: A review

Fakheri

Bari

Aarabi

et al. 2014

WJG

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The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. However, no review article has yet evaluated and compared the efficacy of different regimens among different countries of this region. Therefore, we conducted a review to select the best options and provide recommendations for H. pylori treatment in this geographic region. A search through PubMed was carried out to obtain relevant randomized clinical trials published in English language up to June 2013. According to the results, among different therapeutic regimens used as the first-line protocols, 10-d Bismuth-Furazolidone/Metronidazole quadruple therapy, 14-d Clarithromycin-containing hybrid therapy and 14-d quadruple therapy including a proton pump inhibitor + Bismuth + Tetracycline (500 mg QID) + Metronidazole (500 mg TDS) seemed to be appropriate options. Among second-line therapeutic regimens, Bismuthbased quadruple therapies containing Tetracycline and Furazolidone/Metronidazole, triple therapy containing Amoxicillin and Gatifloxacin and Quadruple therapy including Bismuth + Azithromycin and Ofloxacin seemed to be effective options. Third-line therapies were not evaluated in West Asia; most guidelines, however, recommend choosing optimal eradication regimen according to the pattern of antibiotic susceptibility of H. pylori . Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same. Core tip: The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. The present study evaluates and compares the efficacy of different regimens among different countries of this region. Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same.

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Low Helicobacter pylori eradication rates with 4‐ and 7‐day regimens in an Iranian population

Abstract: Treatment regimens of 4 or 7 days are unacceptable for H. pylori infection in Iran, even in the presence of a favorable sensitivity profile.

Cited by 32 publications

References 29 publications

Azithromycin based triple therapy versus standard clarithromycin based triple therapy in eradication of Helicobacter pylori infection in Iran: a randomized controlled clinical trial

Azithromycin based triple therapy versus standard clarithromycin based triple therapy in eradication of Helicobacter pylori infection in Iran: a randomized controlled clinical trial

Triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies for H pylori eradication: A comparative three-armed randomized clinical trial

Helicobacter pylorieradication in West Asia: A review

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