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Ranitidine bismuth citrate-based triple therapies as a second-line therapy for Helicobacter pylori in Turkish patients.

Abstract

BACKGROUND

Quadruple therapy with a proton pump inhibitor, bismuth, metronidazole and tetracycline is recommended as the optimal second-line therapy of Helicobacter pylori infection in the Maastricht Consensus Report. The aim of the present paper was to evaluate the efficacy of ranitidine bismuth citrate (RBC)-based regimens as second-line therapies after failure of the standard Maastricht triple therapy.

MATERIALS AND METHODS

One hundred and sixteen H. pylori-positive patients were given omeprazole 20 mg b.d., clarithromycin 500 mg b.d., and amoxicillin 1 g b.d for 10 days. Patients remaining H. pylori-positive (n = 29) were combined with 27 patients enrolled after an initial eradication failure from proton-pump inhibitor (PPI), amoxicillin and clarithromycin therapy for at least 7 days and were randomly given one of the following second-line 10-day treatments: RBC 400 mg b.d., amoxicillin 1 g b.d and clarithromycin 500 mg b.d. (RAC group, n = 28) and RBC 400 mg b.d., metronidazole 500 mg b.d and tetracycline 500 mg b.d. (RMT group, n = 28). Eradication was assessed by either histology and rapid urease test or (13)C urea breath test 8 weeks after therapy.

RESULTS

The eradication rate of first-line Maastricht therapy was 67% for intention-to-treat analysis (95% confidence interval [CI]: 58-75). Per-protocol and intention-to-treat eradication was achieved in 60.7% of patients (95%CI: 42-79) in the RAC group and in 85.7% of patients (95%CI: 73-98) in the RMT group (P = 0.03). Fifty-three percent of patients in the RAC and 50% of patients in the RMT group experienced at least one slight side-effect (P = 0.6).

CONCLUSIONS

RMT is an effective and well-tolerated second-line therapy after H. pylori eradication failure from PPI, amoxicillin, and clarithromycin.

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  • Authors+Show Affiliations

    ,

    Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. dckoksal@hotmail.com

    , , , , , , ,

    Source

    MeSH

    Adult
    Amoxicillin
    Anti-Bacterial Agents
    Anti-Ulcer Agents
    Bismuth
    Breath Tests
    Chi-Square Distribution
    Clarithromycin
    Drug Therapy, Combination
    Female
    Helicobacter Infections
    Helicobacter pylori
    Humans
    Male
    Metronidazole
    Middle Aged
    Omeprazole
    Prospective Studies
    Ranitidine
    Tetracycline
    Treatment Outcome
    Turkey

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    15836716

    Citation

    Köksal, Aydin S., et al. "Ranitidine Bismuth Citrate-based Triple Therapies as a Second-line Therapy for Helicobacter Pylori in Turkish Patients." Journal of Gastroenterology and Hepatology, vol. 20, no. 4, 2005, pp. 637-42.
    Köksal AS, Parlak E, Filik L, et al. Ranitidine bismuth citrate-based triple therapies as a second-line therapy for Helicobacter pylori in Turkish patients. J Gastroenterol Hepatol. 2005;20(4):637-42.
    Köksal, A. S., Parlak, E., Filik, L., Yolcu, O. F., Odemiş, B., Ulker, A., ... Sahin, B. (2005). Ranitidine bismuth citrate-based triple therapies as a second-line therapy for Helicobacter pylori in Turkish patients. Journal of Gastroenterology and Hepatology, 20(4), pp. 637-42.
    Köksal AS, et al. Ranitidine Bismuth Citrate-based Triple Therapies as a Second-line Therapy for Helicobacter Pylori in Turkish Patients. J Gastroenterol Hepatol. 2005;20(4):637-42. PubMed PMID: 15836716.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Ranitidine bismuth citrate-based triple therapies as a second-line therapy for Helicobacter pylori in Turkish patients. AU - Köksal,Aydin S, AU - Parlak,Erkan, AU - Filik,Levent, AU - Yolcu,Omer F, AU - Odemiş,Bülent, AU - Ulker,Aysel, AU - Saşmaz,Nurgül, AU - Ozden,Ali, AU - Sahin,Burhan, PY - 2005/4/20/pubmed PY - 2005/8/3/medline PY - 2005/4/20/entrez SP - 637 EP - 42 JF - Journal of gastroenterology and hepatology JO - J. Gastroenterol. Hepatol. VL - 20 IS - 4 N2 - BACKGROUND: Quadruple therapy with a proton pump inhibitor, bismuth, metronidazole and tetracycline is recommended as the optimal second-line therapy of Helicobacter pylori infection in the Maastricht Consensus Report. The aim of the present paper was to evaluate the efficacy of ranitidine bismuth citrate (RBC)-based regimens as second-line therapies after failure of the standard Maastricht triple therapy. MATERIALS AND METHODS: One hundred and sixteen H. pylori-positive patients were given omeprazole 20 mg b.d., clarithromycin 500 mg b.d., and amoxicillin 1 g b.d for 10 days. Patients remaining H. pylori-positive (n = 29) were combined with 27 patients enrolled after an initial eradication failure from proton-pump inhibitor (PPI), amoxicillin and clarithromycin therapy for at least 7 days and were randomly given one of the following second-line 10-day treatments: RBC 400 mg b.d., amoxicillin 1 g b.d and clarithromycin 500 mg b.d. (RAC group, n = 28) and RBC 400 mg b.d., metronidazole 500 mg b.d and tetracycline 500 mg b.d. (RMT group, n = 28). Eradication was assessed by either histology and rapid urease test or (13)C urea breath test 8 weeks after therapy. RESULTS: The eradication rate of first-line Maastricht therapy was 67% for intention-to-treat analysis (95% confidence interval [CI]: 58-75). Per-protocol and intention-to-treat eradication was achieved in 60.7% of patients (95%CI: 42-79) in the RAC group and in 85.7% of patients (95%CI: 73-98) in the RMT group (P = 0.03). Fifty-three percent of patients in the RAC and 50% of patients in the RMT group experienced at least one slight side-effect (P = 0.6). CONCLUSIONS: RMT is an effective and well-tolerated second-line therapy after H. pylori eradication failure from PPI, amoxicillin, and clarithromycin. SN - 0815-9319 UR - https://www.unboundmedicine.com/medline/citation/15836716/Ranitidine_bismuth_citrate_based_triple_therapies_as_a_second_line_therapy_for_Helicobacter_pylori_in_Turkish_patients_ L2 - https://doi.org/10.1111/j.1440-1746.2005.03801.x DB - PRIME DP - Unbound Medicine ER -