One week triple therapy with omeprazole, clarithromycin and tinidazole for <i>Helicobacter pylori</i>: differing efficacy in previously treated and untreated patients

Moshkowitz, Menachem; Konikoff, Fred M.; Peled, Yael; Brill, Shai; Hallak, Aharon; Tiomny, E; Santo, M; Bujanover, Yoram; Gilat, T

doi:10.1046/j.1365-2036.1996.96268000.x

Cited by 36 publications

(29 citation statements)

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“…Consistent with the European studies, the resistant rates were significantly higher in patients treated for the second (46%) or third time (65%) ( Table 2) [26][27][28][29][30][31][32]. Consistent with the European studies, the resistant rates were significantly higher in patients treated for the second (46%) or third time (65%) ( Table 2) [26][27][28][29][30][31][32].…”

Section: Discussionsupporting

confidence: 75%

High Eradication Rates of Helicobacter pylori Infection Following Sequential Therapy: The Israeli Experience Treating Naïve Patients

Schmiloviz-Weiss¹,

Shalev²,

Chechoulin³

et al. 2011

Helicobacter

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Section: Discussionsupporting

confidence: 75%

High Eradication Rates of Helicobacter pylori Infection Following Sequential Therapy: The Israeli Experience Treating Naïve Patients

Schmiloviz-Weiss¹,

Shalev²,

Chechoulin³

et al. 2011

Helicobacter

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“…We had reported earlier that the success rate was significantly lower with this regimen in adult patients in whom attempts to resolve H pylori previously with standard bismuth and metronidazolecontaining triple therapy had failed. 18 The explanation for this is not clear. Acquired metronidazole resistance does not seem to be responsible, because a similar observation was seen in a combination therapy that did not contain nitroimidazole.…”

Section: Discussionmentioning

confidence: 89%

“…24 However, this has been found only with treatment with the standard bismuth-containing triple therapy, but not with the OCT triple therapy discussed here. 18 A significant proportion of our patients were recent immigrants from the former USSR. This correlates with our clinical impression of high prevalence of peptic ulcer disease in this population group.…”

Section: Discussionmentioning

confidence: 99%

“…Dual therapy with omeprazole and amoxicillin for 14 days resulted in poor and unsatisfactory outcomes for patients of all ages. 18 The low-dose, 1-week triple therapy with OCT, first described by Bazzoli et al, 13 is believed to provide an answer for most of the problems noted above. This regimen was found to be highly effective in several studies in adults, with success rates of 90% to 95%.…”

Section: Discussionmentioning

confidence: 99%

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One-Week Triple Therapy With Omeprazole, Clarithromycin, and Nitroimidazole forHelicobacter pyloriInfection in Children and Adolescents

Moshkowitz¹,

Reif

Brill³

et al. 1998

Pediatrics

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ABSTRACT. Background. Resolution of Helicobacter pylori infection is important in the management of peptic ulcer disease and reduces peptic ulcer recurrence in both adults and children. Various anti-H pylori treatment regimens have been proposed, reflecting the incomplete clinical success of each. A combination of omeprazole, clarithromycin, and tinidazole, given for 1 week, has been shown to be highly tolerable and effective, achieving a success rate of >90% in the adult population.Objective. The aim of this study was to evaluate this short-term regimen in pediatric and adolescent populations.Methods. The study group consisted of 35 children referred for evaluation of dyspeptic symptoms. They all underwent upper gastrointestinal endoscopy, in which H pylori infection was confirmed by rapid urease test and/or histologic staining. They were given omeprazole (20 mg twice daily), clarithromycin (250 mg twice daily), and tinidazole or metronidazole (500 mg twice daily) for 1 week. The patients were divided into two groups: those who received the first course of anti-H pylori therapy during this study (group 1) and those who had previously received standard metronidazole and bismuth combination therapies that failed to eradicate H pylori (group 2). Therapeutic efficacy was assessed by a 13 C-urea breath test performed 4 weeks after completion of treatment.Results. The 35 study patients had a mean age of 15.9 years (range, 10 to 19) and included 19 males and 16 females, of whom 22 were born in Israel and 13 were immigrants from the former USSR. There were 27 patients (77.1%) in group 1 and 8 patients (22.9%) in group 2. Endoscopic findings were nodular gastritis (14), gastritis (11), gastric ulcer (1), duodenal ulcer (5), and duodenitis (4). H pylori resolution was significantly higher in group 1 patients (24/27, 88.9%) than in group 2 patients (1/8, 12.5%). There was no difference between patients with nodular gastritis and those with nonnodular gastritis, and between Israeli-born patients and patients born in the former USSR. Compliance in both groups was equally good, and no major side effects were recorded.Conclusions. One-week omeprazole/clarithromycin/ tinidazole triple therapy is highly tolerable and effective for treating H pylori in the pediatric age group, but previous treatment failure diminishes the likelihood of success with this regimen. Pediatrics 1998;102(1). URL: http://www.pediatrics.org/cgi/content/full/102/1/e14; Helicobacter pylori, triple therapy, children, adolescents, omeprazole, clarithromycin.

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“…As previous treatment failure leads to the development of secondary bacterial resistance to both metronidazole and clarithromycin30 and the efficacy of retreatment is also significantly decreased by the number of previous treatments,47 it is understandable that the higher success rate with the first line treatment, the lower will be the treatment failure. Thus, choosing the best available first line treatment regimen should be considered to be the best approach to “rescue” treatment.…”

Section: What Is the Best “Rescue” Strategy?mentioning

confidence: 99%

Treatment after failure: the problem of "non-responders"

Hunt

1999

Gut

119

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SummaryAlthough the currently most eVective treatment regimens cure about 90% of infections, 10% of patients remain Helicobacter pylori positive. Several factors contribute to treatment failure. These include patient compliance, bacterial resistance to antibiotics, and treatment related issues. Treatment failure leads to the development of bacterial resistance to metronidazole and clarithromycin. Retreatment can be undertaken after considering several diVerent strategies: to repeat the same regimen with full doses of medications and a longer treatment duration, or to choose diVerent regimens to avoid the antibiotic previously used, or to switch to proton pump inhibitor (PPI) based quadruple therapy or ranitidine bismuth citrate (RBC) based triple therapy. In principle, full doses and longer treatment durations are advisable. As retreatment is always diYcult, choosing the best available first line treatment regimen is still the best "rescue" treatment.

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One week triple therapy with omeprazole, clarithromycin and tinidazole for Helicobacter pylori: differing efficacy in previously treated and untreated patients

Cited by 36 publications

References 0 publications

High Eradication Rates of Helicobacter pylori Infection Following Sequential Therapy: The Israeli Experience Treating Naïve Patients

High Eradication Rates of Helicobacter pylori Infection Following Sequential Therapy: The Israeli Experience Treating Naïve Patients

One-Week Triple Therapy With Omeprazole, Clarithromycin, and Nitroimidazole forHelicobacter pyloriInfection in Children and Adolescents

Treatment after failure: the problem of "non-responders"

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