The outcome of a 2-week treatment of Helicobacter pylori-positive duodenal ulcer with omeprazole-based antibiotic regimen in a region with high metronidazole resistance rate
| Autor: | Thanaa El A Helal, Edward O. Adeyemi, Moheb F. Danial, Sheela Benedict, Abdishakur M. Abdulle |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Biopsy Antibiotics Rapid urease test Gastroenterology Helicobacter Infections Clarithromycin Metronidazole Internal medicine medicine Humans Prospective Studies Prospective cohort study Omeprazole Helicobacter pylori Hepatology biology business.industry Contraindications Amoxicillin Drug Resistance Microbial Middle Aged biology.organism_classification Anti-Bacterial Agents Treatment Outcome Duodenal Ulcer Female business medicine.drug |
| Zdroj: | European Journal of Gastroenterology & Hepatology. 11:1259-1264 |
| ISSN: | 0954-691X |
| DOI: | 10.1097/00042737-199911000-00013 |
| Popis: | BACKGROUND/OBJECTIVE Metronidazole resistance is a major problem in many developing countries. Our main objective was to study the outcome of a non-metronidazole and omeprazole-based antibiotic regimen in eradicating Helicobacter pylori in patients with duodenal ulcer. DESIGN A prospective study of 50 consecutive patients with proven peptic ulcer (mean age 36.6 +/- 10.5 years, range 17-60, male:female = 2), referred from the primary health centres. MAIN OUTCOME MEASURE The primary outcome of the study was H. pylori eradication, at least 4 weeks after stopping antibiotic treatment. METHODS Patients were considered eligible for the study if they had endoscopic evidence or a past medical history of peptic ulcer and had not received any antibiotics for at least 4 weeks prior to admission into the study. H. pylori infection was confirmed by serology, histology, a rapid urease test (RUT) and culture. After an initial oesophago-gastroduodenoscopy (OGD), each patient received a 2-week course of omeprazole (20 mg twice daily), and each of amoxycillin capsules (500 mg) and clarithromycin tablets (250 mg) thrice daily after food. The follow-up OGDs were performed after a mean period of 10.04 weeks (range 4-48) and at 10.4 +/- 2.5 months (range 6-14 months) after stopping treatment. RESULTS All 50 patients completed the study. The sensitivity values for serology, RUT and histopathology were 98, 96 and 100%, respectively. H. pylori culture was positive in only 15 of 50 patients (30% sensitivity). H. pylori was eradicated in 47 (94%) patients. There was no evidence of H. pylori infection in the 27 of 35 (77%) patients, who returned for a third OGD. At the time of the second OGD, there was a significant reduction of pain-days (from 5.47 to 1.16), and antral (from 1.95 to 0.78) and corpus (from 1.8 to 0.6) mucosal cellular infiltrate scores, when compared with the first OGD (P < 0.001 in each case). CONCLUSION Exclusion of metronidazole from the treatment regimen of patients with H. pylori-positive duodenal ulcer in a region with metronidazole resistance yielded an excellent H. pylori eradication rate of 94%, when omeprazole, amoxicillin and clarithromycin were used. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|