Two‐week dual vs. one‐week triple therapy for cure of<i>Helicobacter pylori</i>infection in primary care: a multicentre, randomized trial

Calvet, Xavier; López‐Lorente, M. ‐T.; Cubells, Monique; Baré, Marisa; Galvez, Eleuterio; Molina, E

doi:10.1046/j.1365-2036.1999.00552.x

Cited by 27 publications

(27 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 Guidelines for treating H. pylori infection have changed progressively since 1984. 15,16 Most current consensus reports recommend triple therapy combining a proton pump inhibitor with two antibiotics, normally clarithromycin plus amoxicillin or an imidazole. 15,16 Most current consensus reports recommend triple therapy combining a proton pump inhibitor with two antibiotics, normally clarithromycin plus amoxicillin or an imidazole.…”

Section: Introductionmentioning

confidence: 99%

“…However, it was reported to have severe adverse effects 18 and poor compliance because of the complex dosage. 16,[23][24][25] Prolonging therapy to 14 days increases the eradication to some degree; per protocol eradication rates approach 90%. 20,21 In addition, pilot studies have shown that simplified quadruple therapy may be used as a firstline option.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Triple vs. quadruple therapy for treating Helicobacter pylori infection: an updated meta‐analysis

Gené

Calvet

Azagra

et al. 2003

Aliment Pharmacol Ther

Self Cite

View full text Add to dashboard Cite

Triple vs. quadruple therapy for treating Helicobacter pylori infection: an updated meta-analysis Sirs, Since we submitted our paper, ÔTriple vs. quadruple therapy for treating Helicobacter pylori infection: a meta-analysisÕ, for publication in Alimentary Pharmacology and Therapeutics, 1 a new study comparing triple with quadruple therapy has been published. 2 Full-text reports of two of the studies included in the metaanalysis in abstract form have also been published. 3, 4The objective of this letter is to update the meta-analysis using these new results. whereas there are small differences between the abstract and full-text form of the paper by Laine et al. 4The results of our meta-analysis did not change after introducing these modifications ( Figure 1). In the intention-to-treat analysis, eradication was achieved in 449 of 559 patients with quadruple therapy [80%; 95% confidence interval (CI), 77-84%] and in 451 of 569 patients with triple therapy (79%; 95% CI, 74-81%). The odds ratio (Figure 1) was 1.00 (95% CI, 0.64-1.57; P ¼ 1). In the per protocol analysis, eradication was achieved in 421 of 486 patients with quadruple therapy (87%; 95% CI, 84.1-90.5%) and in 435 of 509 patients with triple therapy (85%; 95% CI, 81.4-88.3%). The odds ratio was 0.95 (95% CI, 0.58-1.57; P ¼ 0.9).In conclusion, the update of our meta-analysis suggests that the conclusions of the previous report can be maintained, and that the effectiveness of quadruple and triple therapy is very similar for the initial treatment of H. pylori infection.E. Gené *, X. Calvet , R.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Triple vs. quadruple therapy for treating Helicobacter pylori infection: an updated meta‐analysis

Gené

Calvet

Azagra

et al. 2003

Aliment Pharmacol Ther

Self Cite

View full text Add to dashboard Cite

show abstract

“…Failure to cure H. pylori infection has been noted for more than 20 to 30% of patients (37). In addition, several studies have found an eradication rate lower than 75% (6,11,59), and values as low as 25 to 45% have also been recently reported (22,24). Thus, prolonged standard triple therapy for up to 2 weeks has been recommended (9,23,34), and in cases of eradication failure, a quadruple therapy with a proton pump inhibitor, bismuth salt, tetracycline, and metronidazole has been advised as a second-line therapy (8,13,44).…”

mentioning

confidence: 99%

In Vitro Antibacterial Activity of Acyl-Lysyl Oligomers againstHelicobacter pylori

Makobongo

Kovachi

Gancz

et al. 2009

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The gastric pathogen Helicobacter pylori has developed resistance to virtually all current antibiotics; thus, there is a pressing need to develop new anti-H. pylori therapies. The goal of this work was to evaluate the antibacterial effect of oligo-acyl-lysyl (OAK) antimicrobial peptidomimetics to determine if they might represent alternatives to conventional antibiotic treatment of H. pylori infection. A total of five OAK sequences were screened for growthinhibitory and/or bactericidal effects against H. pylori strain G27; four of these sequences had growth-inhibitory and bactericidal effects. The peptide with the highest efficacy against strain G27, C 12 K-2␤ 12 , was selected for further characterization against five additional H. pylori strains (26695, J99, 7.13, SS1, and HPAG1). C 12 K-2␤ 12 displayed MIC and minimum bactericidal concentration (MBC) ranges of 6.5 to 26 M and 14.5 to 90 M, respectively, across the six strains after 24 h of exposure. G27 was the most sensitive H. pylori strain (MIC ‫؍‬ 6.5 to 7 M; MBC ‫؍‬ 15 to 20 M), whereas 26695 was the least susceptible strain (MIC ‫؍‬ 25 to 26 M; MBC ‫؍‬ 70 to 90 M). H. pylori was completely killed after 6 to 8 h of incubation in liquid cultures containing two times the MBC of C 12 K-2␤ 12 . The OAK demonstrated strong in vitro stability, since efficacy was maintained after incubation at extreme temperatures (4°C, 37°C, 42°C, 50°C, 55°C, 60°C, and 95°C) and at low pH, although reduced killing kinetics were observed at pH 4.5. Additionally, upon transient exposure to the bacteria, C 12 K-2␤ 12 showed irreversible and significant antibacterial effects and was also nonhemolytic. Our results show a significant in vitro effect of C 12 K-2␤ 12 against H. pylori and suggest that OAKs may be a valuable resource for the treatment of H. pylori infection.Helicobacter pylori is a microaerophilic gram-negative bacterium that colonizes the gastric mucosa. It is known to be a principal gastric pathogen of humans and is associated with the development of gastritis, gastric ulcers, duodenal ulcers, and gastric cancer (46,55,56,60). Approximately half of the world's population is infected with H. pylori (79). Thus, the bacterium poses a significant public health problem, which is further compounded by the fact that H. pylori has developed antimicrobial resistance to virtually all current antibiotics, a phenomenon that is hampering efforts to treat the infection (40, 51).Since the original isolation of H. pylori in the early 1980s, treatment of the bacterial infection has undergone a significant evolutionary development from initial monotherapy to dual, triple, and in more recent trials quadruple therapy (8, 18). Current treatment strategies employ combination therapy, since single-antibiotic therapy often results in failure to eradicate the infection (21). The highest H. pylori eradication rates have been reported with triple therapy, which involves the utilization of two antibiotics in combination with bismuth or a proton pump inhibitor, PPI (34,44). Amoxicillin (amoxicil...

show abstract

“…Triple therapies are the mainstay of current treatment but resistance to clarithromycin is reducing its effectiveness. In the presence of resistance to clarithromycin, some studies have shown eradication rate below 80% and even as low as 25%-61% with standard triple therapy containing clarithromycin, amoxycillin and a proton-pump inhibitor [7][8][9][10][11] . Clarithromycin resistance is also increasing in our region [12,13] .…”

Section: Introductionmentioning

confidence: 99%

Treatment of Helicobacter pylori in surgical practice: A randomised trial of triple versus quadruple therapy in a rural district general hospital

Ching¹,

Sabanathan²,

Jenkinson³

2008

WJG

View full text Add to dashboard Cite

AIM:To compare a lansoprazole-based triple versus quadruple therapy for Helicobacter pylori (H pylori) eradication with emphasis on side effect profile, patient compliance and eradication rate at a rural district general hospital in Wales, United Kingdom. C urea breath test 2 mo after treatment. RESULTS: Seven patients were withdrawn after randomisation. Fifty patients were assigned to LAC group and 44 to LMBT group. The intention-to-treat cure rates were 92% and 91%, whereas the perprotocol cure rates were 92% and 97%, respectively. Side effects were common, with 56% experiencing moderate to severe symptoms in the LAC group and 59% in the LMBT group. Symptoms of vomiting, diarrhoea and black stools were significantly more common in the LMBT group. Patient compliance was 100% for triple therapy and 86% for quadruple therapy (P < 0.01). One-third of patients in both groups were still taking acid-reducing medications at six-month follow-up. CONCLUSION: One-week triple and quadruple therapies have similar intention-to-treat eradication rates. Certain side effects are more common with quadruple therapy, which can compromise patient compliance. Patient education or modifications to the regimen are alternative options to improve compliance of the quadruple regimen. METHODS:

show abstract

Two‐week dual vs. one‐week triple therapy for cure ofHelicobacter pyloriinfection in primary care: a multicentre, randomized trial

Cited by 27 publications

References 23 publications

Triple vs. quadruple therapy for treating Helicobacter pylori infection: an updated meta‐analysis

Triple vs. quadruple therapy for treating Helicobacter pylori infection: an updated meta‐analysis

In Vitro Antibacterial Activity of Acyl-Lysyl Oligomers againstHelicobacter pylori

Treatment of Helicobacter pylori in surgical practice: A randomised trial of triple versus quadruple therapy in a rural district general hospital

Contact Info

Product

Resources

About