Pilot study: miscellaneous therapy is highly successful forHelicobacter pylorieradication

Autor:	Fernando Sierra, M. L. Botero, J. D. Forero, M. Rey, Andrés Cárdenas
Rok vydání:	2013
Předmět:	Adult Male Peptic Ulcer medicine.medical_specialty Lansoprazole Rapid urease test Pilot Projects Gastroenterology Helicobacter Infections Pharmacotherapy Clarithromycin Metronidazole Surveys and Questionnaires Internal medicine Gastroscopy medicine Humans Pharmacology (medical) Prospective Studies Adverse effect Helicobacter pylori Hepatology biology business.industry Amoxicillin Proton Pump Inhibitors Gastric Acidity Determination Hydrogen-Ion Concentration Middle Aged biology.organism_classification Anti-Bacterial Agents Treatment Outcome Gastritis Drug Therapy Combination Female business medicine.drug
Zdroj:	Alimentary Pharmacology & Therapeutics. 37:1165-1171
ISSN:	0269-2813
Popis:	Summary Background Success in H. pylori eradication with conventional therapies has decreased to unacceptable levels (≤80%). New schemes of combined treatment are currently needed. Aim To test a miscellaneous therapy for H. pylori eradication. Methods/patients Open-label, pilot, single-centre and prospective study. Patients received a 15-day treatment scheme that consisted of 5 initial days of lansoprazole 30 mg b.d., amoxicillin 1 g b.d., and metronidazole 500 mg t.d.s.; days 6 to 10: lansoprazole 30 mg q.d.s. and metronidazole 500 mg t.d.s.; days 11 to 15: lansoprazole 30 mg b.d., clarithromycin 500 mg b.d. and metronidazole 500 mg t.d.s. Each patient underwent an upper endoscopy before treatment and a second follow-up endoscopy at least 4 weeks after therapy. Success was defined on the basis of an eradication rate following a per-protocol analysis ≥95%. Biopsies before and after therapy were obtained for histological evaluation and rapid urease test. Results One hundred and twenty-two patients were enrolled and 118 patients completed the study. The eradication rate for H. pylori with miscellaneous therapy was 94% (confidence Interval (CI) 95%, 90–98.3%) in the per-protocol analysis (PP) and 91% (95% CI, 86–96%) in the intention-to-treat (ITT) analysis. Adherence to treatment was 96% (113 patients). Among patients who completed treatment, 55% presented adverse events, mainly nausea and abdominal pain. Conclusion A miscellaneous therapy, based on the combination of multiple medications in high doses for 2 weeks, and with gastric pH elevation, is a highly effective treatment as a first-line therapy for the eradication of H. pylori.
Databáze:	OpenAIRE
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