One week triple therapy for Helicobacter pylori: a multicentre comparative study

Autor:	G. D. Kerr, B T Cooper, H Langworthy, D Piper, J. J. Misiewicz, S Levi, Colm O'Morain, Michael F. Dixon, K D Bardhan, A W Harris
Rok vydání:	1997
Předmět:	Breath test medicine.medical_specialty medicine.diagnostic_test biology business.industry Urea breath test Gastroenterology Lansoprazole Helicobacter pylori biology.organism_classification Metronidazole Clarithromycin Internal medicine medicine business Omeprazole medicine.drug Antibacterial agent
Zdroj:	Gut. 41:735-739
ISSN:	1468-3288 0017-5749
Popis:	Background—Eradication ofHelicobacter pylori cures and prevents the relapse of duodenal ulceration and also results in histological resolution of chronic active gastritis. Aim—To compare four treatment regimens lasting seven days of a proton pump inhibitor and two antibiotics in the eradication of H pylori.Patients—Men or women with H pylori positive duodenal ulceration or gastritis, or both.Methods—A single blind, prospectively randomised, parallel group, comparative, multicentre study. After a positive CLO test, patients underwent histology, H pylori culture, and a 13C urea breath test to confirm H pyloristatus. Treatment with one of four regimens: LAC, LAM, LCM, or OAM, where L is 30 mg of lansoprazole twice daily, A is 1 g of amoxycillin twice daily, M is 400 mg of metronidazole twice daily, C is 250 mg of clarithromycin twice daily, and O is 20 mg of omeprazole twice daily, was assigned randomly. A follow up breath test was done at least 28 days after completing treatment.Results—H pylori eradication (intention to treat) was 104/121 (86.0%) with LAC, 87/131 (66.4%) with LAM, 103/118 (87.3%) with LCM, and 94/126 (74.6%) with OAM. There was a significant difference (p < 0.001) in the proportion of patients in whom eradication was successful between LAC and LCM when compared with LAM, but no significant difference (p = 0.15) between LAM and OAM. Metronidazole resistance before treatment was identified as a significant prognostic factor with regard to eradication of H pylori. The regimens which contained metronidazole were significantly less effective than those without metronidazole in the presence of pretreatment resistant H pylori. There was no difference among the treatment groups with regard to the incidence and severity of adverse events reported. Conclusions—All four treatment regimens were safe and effective in eradicating H pylori in the patient population studied. LAC was the most efficacious treatment in patients with pretreatment metronidazole resistant H pylori, and was significantly better than LAM and OAM in this group of patients.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::4cb737ee14bb454282bd7f9721e9a3a7 https://doi.org/10.1136/gut.41.6.735 Zobrazit plný text záznamu