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Modified seven-day, quadruple therapy as a first line Helicobacter pylori treatment.

Abstract

BACKGROUND

Cure rates of 7-day triple therapy seem to be decreasing. Quadruple therapies may be an alternative, although their complex administration makes patient acceptance difficult.

OBJECTIVE

To test the usefulness of a thrice a day, quadruple therapy to cure Helicobacter pylori infection.

PATIENTS AND METHODS

A total of 122 consecutive patients with peptic ulcer and Helicobacter pylori infection were treated with omeprazole 20 mg b.d., tetracycline chlorhydrate 500 mg t.d.s., metronidazole 500 mg t.d.s., and bismuth subcitrate 120 mg t.d.s. administered with meals for 7 days. Cure was tested by either endoscopy or breath test after 2 months, and by urea breath test 6 months after therapy.

RESULTS

Seven patients were lost to follow-up. Of the remaining 115, 110 were cured at the first control, giving an intention-to-treat cure rate of 90.2% (95% CI: 83-95%) and a per protocol cure rate of 95.7% (95% CI: 90-98%). One hundred three patients returned for a 6-month breath test; all but one were cured. Side-effects were minimal or minor in 47 patients (40.8%) and moderate in four (3.4%). Compliance was good, 95% of patients taking more than 90% of the pills. Six (5%) patients stopped treatment after 1, 2, 4 (two patients) and 6 (two patients) days.

CONCLUSION

Thrice a day quadruple therapy shows excellent cure rates, far above 90%, is well-tolerated and compliance is easy. Head-to-head comparison with triple therapies as first line Helicobacter pylori treatment seems warranted.

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  • Authors+Show Affiliations

    ,

    Department of Surgery, Corporació Sanitária Parc Taulí, Sabadell, Spain. xcalvet@cspt.es

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    Source

    MeSH

    Administration, Oral
    Adult
    Aged
    Anti-Bacterial Agents
    Anti-Ulcer Agents
    Drug Administration Schedule
    Drug Therapy, Combination
    Female
    Helicobacter Infections
    Helicobacter pylori
    Humans
    Male
    Metronidazole
    Middle Aged
    Omeprazole
    Organometallic Compounds
    Patient Compliance
    Peptic Ulcer
    Tetracycline
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Journal Article

    Language

    eng

    PubMed ID

    11421883

    Citation

    Calvet, X, et al. "Modified Seven-day, Quadruple Therapy as a First Line Helicobacter Pylori Treatment." Alimentary Pharmacology & Therapeutics, vol. 15, no. 7, 2001, pp. 1061-5.
    Calvet X, Garcia N, Gené E, et al. Modified seven-day, quadruple therapy as a first line Helicobacter pylori treatment. Aliment Pharmacol Ther. 2001;15(7):1061-5.
    Calvet, X., Garcia, N., Gené, E., Campo, R., Brullet, E., & Sanfeliu, I. (2001). Modified seven-day, quadruple therapy as a first line Helicobacter pylori treatment. Alimentary Pharmacology & Therapeutics, 15(7), pp. 1061-5.
    Calvet X, et al. Modified Seven-day, Quadruple Therapy as a First Line Helicobacter Pylori Treatment. Aliment Pharmacol Ther. 2001;15(7):1061-5. PubMed PMID: 11421883.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Modified seven-day, quadruple therapy as a first line Helicobacter pylori treatment. AU - Calvet,X, AU - Garcia,N, AU - Gené,E, AU - Campo,R, AU - Brullet,E, AU - Sanfeliu,I, PY - 2001/6/26/pubmed PY - 2001/8/10/medline PY - 2001/6/26/entrez SP - 1061 EP - 5 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 15 IS - 7 N2 - BACKGROUND: Cure rates of 7-day triple therapy seem to be decreasing. Quadruple therapies may be an alternative, although their complex administration makes patient acceptance difficult. OBJECTIVE: To test the usefulness of a thrice a day, quadruple therapy to cure Helicobacter pylori infection. PATIENTS AND METHODS: A total of 122 consecutive patients with peptic ulcer and Helicobacter pylori infection were treated with omeprazole 20 mg b.d., tetracycline chlorhydrate 500 mg t.d.s., metronidazole 500 mg t.d.s., and bismuth subcitrate 120 mg t.d.s. administered with meals for 7 days. Cure was tested by either endoscopy or breath test after 2 months, and by urea breath test 6 months after therapy. RESULTS: Seven patients were lost to follow-up. Of the remaining 115, 110 were cured at the first control, giving an intention-to-treat cure rate of 90.2% (95% CI: 83-95%) and a per protocol cure rate of 95.7% (95% CI: 90-98%). One hundred three patients returned for a 6-month breath test; all but one were cured. Side-effects were minimal or minor in 47 patients (40.8%) and moderate in four (3.4%). Compliance was good, 95% of patients taking more than 90% of the pills. Six (5%) patients stopped treatment after 1, 2, 4 (two patients) and 6 (two patients) days. CONCLUSION: Thrice a day quadruple therapy shows excellent cure rates, far above 90%, is well-tolerated and compliance is easy. Head-to-head comparison with triple therapies as first line Helicobacter pylori treatment seems warranted. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/11421883/Modified_seven_day_quadruple_therapy_as_a_first_line_Helicobacter_pylori_treatment_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0269-2813&date=2001&volume=15&issue=7&spage=1061 DB - PRIME DP - Unbound Medicine ER -