Short-term low-dose triple therapy for the eradication of Helicobacter pylori

Bazzoli, Franco; Zagari, Rocco Maurizio; Fossi, S.; Pozzato, P.; Alampi, G; Simoni, Patrizia; Sottiliv, Sandra; Roda, Aldo; Roda, Enrico

doi:10.1097/00042737-199409000-00004

Cited by 263 publications

(210 citation statements)

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“…In our study, the eradication rate (87.5%), was similar to the ones reported by other authors (1,2,4,13,15,16,22) and the metronidazole resistance influenced the therapy outcome in 14.3% of the patients. The higher rates of metronidazole resistance in Brazil can be due its widespread use in gynecological infections and parasitic diseases like giardiasis and amebiasis (27) .…”

Section: Discussionsupporting

confidence: 91%

The impact of Helicobacter pylori resistance on the efficacy of a short course pantoprazole based triple therapy

Eisig¹,

André²,

Silva³

et al. 2003

Arq. Gastroenterol.

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-Background -Many of the currently used Helicobacter pylori eradication regimens fail to cure the infection due to either antimicrobial resistance or poor patient compliance. Those patients will remain at risk of developing potentially severe complications of peptic ulcer disease. Aim -We studied the impact of the antimicrobial resistance on the efficacy of a short course pantoprazole based triple therapy in a single-center pilot study. Methods -Forty previously untreated adult patients (age range 20 to 75 years, 14 males) infected with Helicobacter pylori and with inactive or healing duodenal ulcer disease were assigned in this open cohort study to 1 week twice daily treatment with pantoprazole 40 mg, plus clarithromycin 250 mg and metronidazole 400 mg. Helicobacter pylori was assessed at entry and 50 ± 3 days after the end of treatment by rapid urease test, culture and histology of gastric biopsies. The criteria for eradication was a negative result in the tests. Susceptibility of Helicobacter pylori to clarithromycin and metronidazole was determined before treatment with the disk diffusion test. Results -One week treatment and follow up were complete in all patients. Eradication of Helicobacter pylori was achieved in 35/40 patients (87.5%) and was higher in patients with nitroimidazole-susceptible strains [susceptible: 20/20 (100%), resistant: 10/ 15 (67%)]. There were six (15%) mild adverse events reports. Conclusions -A short course of pantoprazole-based triple therapy is well tolerated and effective in eradicating Helicobacter pylori. The baseline metronidazole resistance may be a significant limiting factor in treatment success.

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Section: Discussionsupporting

confidence: 91%

The impact of Helicobacter pylori resistance on the efficacy of a short course pantoprazole based triple therapy

Eisig¹,

André²,

Silva³

et al. 2003

Arq. Gastroenterol.

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“…A one-week regime of omeprazole 20 mg daily, clarithromycin 250 mg twice daily, and tinidazole 500 mg twice daily, achieved H. pylori eradication in 98% of patients. 3 Similar results are reported with other short-term "triple therapies" with omeprazole.…”

Section: Discussionsupporting

confidence: 76%

Comparison of Dual and Triple Therapy for the Eradication of Helicobacter pylori in Duodenal Ulcer Patients

et al. 1997

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I Tiwari, Z Mazhar, W Uddin, PJH Fletcher, Comparison of Dual and Triple Therapy for the Eradication of Helicobacter Pylori in Duodenal Ulcer Patients. 1997; 17(6): 656-658 Helicobacter pylori (H. pylori) is thought to be responsible for 95% of duodenal ulcers. It is also thought that eradication of this organism will lead to the cure for duodenal ulcers.1 The optimal treatment regime for the eradication of H. pylori has not yet been defined, but the treatment which is effective in developed countries may not be suitable for patients in the developing world. The attempted eradication of H. pylori with antibacterial monotherapy has been not been encouraging. Because of poor compliance and higher side effects from the standard "triple therapy," consisting of bismuth, tetracycline and metronidazole, 2 there is a need to develop a simple, welltolerated regime for the eradication of H. pylori. Recently, a combination therapy with proton pump inhibitors and antibiotics has shown good results for the eradication of this infection. An eradication rate of 98% has been reported with a combination of omeprazole, clarithromycin, and tinidazole for one week.3 Dual therapy with omeprazole and clarithromycin for two weeks gave an eradication rate of 80%. 4 A combination of lansoprazole 30 mg daily for four weeks, and clarithromycin 500 mg three times daily for two weeks, eradicated H. pylori in 54% of patients, 5 while triple therapy with lansoprazole, clarithromycin and metronidazole for one week eradicated the infection in 92% of patients. 6 This combination of therapy has not been tested in patients in the Middle East. We conducted this study to compare the eradication of H. pylori with dual (lansoprazole and clarithromycin) and triple (lansoprazole, clarithromycin and tinidazole) therapy in patients with duodenal ulcer. Patients and MethodsPatients found to have duodenal ulcer on routine gastrointestinal endoscopy were selected for the study. Those with a history of gastrointestinal bleeding, pregnancy or H2 blocker, or antibiotic therapy in the preceding four weeks were excluded. From the eligible patients, three gastric and antral biopsies were taken, one for urease activity (CLO test, Delta West, West Australia), and the other two for histopathology. The tissue for histopathology was fixed in routine formalin fixative and embedded in paraffin wax. Sections were cut at several levels, and stained by hematoxylin and eosin for routine examination, and by the modified Giemsa method for the demonstration of H. pylori. Patients were considered H. pylori-positive if both CLO test and histology were positive. Patients with negative CLO test and histology for H. pylori were excluded from the study. Informed consent was obtained from the H. pylori-positive patients. The study was approved by the local ethics committee.Patients accepted for the study were randomized into two treatment groups by the selection of sealed envelopes. Group A received lansoprazole 30 mg daily for four weeks, and clarithromycin 500 mg twice daily for ...

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“…The eradication rate of H. pylori infection using triple therapy (bismuth and two antibiotics) was reported to be 70-90% (22,23). Treatment failure has been attributed to patient compliance and antimicrobial drug resistance (9)(10)(11) .…”

Section: Discussionmentioning

confidence: 99%

Helicobacter Pylori in Gastric Biopsies of Taiwanese Patients With Gastroduodenal Diseases

Lin

Chang²,

et al. 1998

JJMSB

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SUMMARY: This study was designed to study the in vivo prevalence and the heterogeneity of H, pylori in patients with gastroduodenal diseases in central Taiwan. H. pylori infection was detected in 74.1% (575/776) of the symptomatic population studied. The prevalence of H. pylori infection increased from 11.1% in those between the ages of one to 20, to 82.9% in those between the ages of 41 and 50, and to 84% in those between the ages of 51 and 60. There was no significant difference in the prevalence of H. pylori infection between men and women. Among different blood types, the prevalence and relative risk of H. pylori infection was significantly higher in blood group O patients (90.3%) than in blood group A (41%), blood group B (27.4%), or blood group AB (62%) patients. Metronidazole resistance was found in 6.7% of the primary isolates. The prevalence of metronidazole-resistant H. pylori strains was higher in women (7.69%) than in men (6.25%), but this difference was not significant. A total of 88% of H. pylori strains were cagA-positive. CagA gene-positive strains were present in 90.1% of duodenal ulcers, 90% of duodenal ulcers combined with gastric ulcer, 85.8% of gastric ulcers, and 69.2% of gastritis patients, and was significantly higher in peptic ulcer disease groups than in the gastritis group. In conclusion, there was a low incidence (6.7%) of metronidazole-resistant H. pylori strains and a high prevalence (88%) of H. pylori cagA -positive strains in central 13

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Short-term low-dose triple therapy for the eradication of Helicobacter pylori

Cited by 263 publications

References 0 publications

The impact of Helicobacter pylori resistance on the efficacy of a short course pantoprazole based triple therapy

The impact of Helicobacter pylori resistance on the efficacy of a short course pantoprazole based triple therapy

Comparison of Dual and Triple Therapy for the Eradication of Helicobacter pylori in Duodenal Ulcer Patients

Helicobacter Pylori in Gastric Biopsies of Taiwanese Patients With Gastroduodenal Diseases

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