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Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients.
J Infect Dev Ctries. 2010 Nov 24; 4(11):712-6.JI

Abstract

INTRODUCTION

The scheme proton pump inhibitor/amoxicillin/clarithromycin (PPI/AC) is still the first-line treatment for Helicobacter pylori (H. pylori) infections despite evidence suggesting its failure in up to 20% to 30% of patients.

METHODOLOGY

This study involved 493 patients who were prescribed omeprazole (20 mg twice a day) or another proton pump inhibitor in equivalent dosage, amoxicillin (1 g twice a day), and clarithromycin (500 mg twice a day) for seven days. Efficacy was determined by negative urease test and absence of H. pylori on gastric biopsy samples twelve weeks after the end of treatment. Safety was defined according to the adverse effects reported. Mean age of the patients was (± SD) 48.96 ± 13, and demographic and clinical data were recorded for correlation with treatment outcomes.

RESULTS

Out of 493 patients, 316 (64.1%) presented duodenal ulcer, 111 (22.5%) gastric ulcer, and 66 (14.4%) simultaneous gastric and duodenal ulcers. Additionally, 267 (54.2%) patients had at least one risk factor for peptic ulcer disease, smoking being the most common (99 [36.5%]). Successful eradication was achieved in 408 patients. The eradication rates per protocol, and according to the intention to treat, were 88.8% and 82.7%, respectively. Of 164 (35.5%) patients who presented adverse effects, 100 (61%) reported them as mild and only six (3.7%) patients had to discontinue treatment. Previous use of tobacco and non-steroid anti-inflammatory drugs was the only risk factor for treatment failure (P = 0.00).

CONCLUSION

PPI/AC is still a valuable and remarkably tolerable option for first-line H. pylori eradication in Brazil.

Authors+Show Affiliations

School of Medicine, University of São Paulo, São Paulo, Brazil. guilherme.felga@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

21252448

Citation

Felga, Guilherme, et al. "Clarithromycin-based Triple Therapy for Helicobacter Pylori Treatment in Peptic Ulcer Patients." Journal of Infection in Developing Countries, vol. 4, no. 11, 2010, pp. 712-6.
Felga G, Silva FM, Barbuti RC, et al. Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients. J Infect Dev Ctries. 2010;4(11):712-6.
Felga, G., Silva, F. M., Barbuti, R. C., Navarro-Rodriguez, T., Zaterka, S., & Eisig, J. N. (2010). Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients. Journal of Infection in Developing Countries, 4(11), 712-6.
Felga G, et al. Clarithromycin-based Triple Therapy for Helicobacter Pylori Treatment in Peptic Ulcer Patients. J Infect Dev Ctries. 2010 Nov 24;4(11):712-6. PubMed PMID: 21252448.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients. AU - Felga,Guilherme, AU - Silva,Fernando Marcuz, AU - Barbuti,Ricardo Correa, AU - Navarro-Rodriguez,Tomas, AU - Zaterka,Schlioma, AU - Eisig,Jaime Natan, Y1 - 2010/11/24/ PY - 2010/02/04/received PY - 2010/07/05/accepted PY - 2010/06/26/revised PY - 2011/1/22/entrez PY - 2011/1/22/pubmed PY - 2011/5/13/medline SP - 712 EP - 6 JF - Journal of infection in developing countries JO - J Infect Dev Ctries VL - 4 IS - 11 N2 - INTRODUCTION: The scheme proton pump inhibitor/amoxicillin/clarithromycin (PPI/AC) is still the first-line treatment for Helicobacter pylori (H. pylori) infections despite evidence suggesting its failure in up to 20% to 30% of patients. METHODOLOGY: This study involved 493 patients who were prescribed omeprazole (20 mg twice a day) or another proton pump inhibitor in equivalent dosage, amoxicillin (1 g twice a day), and clarithromycin (500 mg twice a day) for seven days. Efficacy was determined by negative urease test and absence of H. pylori on gastric biopsy samples twelve weeks after the end of treatment. Safety was defined according to the adverse effects reported. Mean age of the patients was (± SD) 48.96 ± 13, and demographic and clinical data were recorded for correlation with treatment outcomes. RESULTS: Out of 493 patients, 316 (64.1%) presented duodenal ulcer, 111 (22.5%) gastric ulcer, and 66 (14.4%) simultaneous gastric and duodenal ulcers. Additionally, 267 (54.2%) patients had at least one risk factor for peptic ulcer disease, smoking being the most common (99 [36.5%]). Successful eradication was achieved in 408 patients. The eradication rates per protocol, and according to the intention to treat, were 88.8% and 82.7%, respectively. Of 164 (35.5%) patients who presented adverse effects, 100 (61%) reported them as mild and only six (3.7%) patients had to discontinue treatment. Previous use of tobacco and non-steroid anti-inflammatory drugs was the only risk factor for treatment failure (P = 0.00). CONCLUSION: PPI/AC is still a valuable and remarkably tolerable option for first-line H. pylori eradication in Brazil. SN - 1972-2680 UR - https://www.unboundmedicine.com/medline/citation/21252448/Clarithromycin_based_triple_therapy_for_Helicobacter_pylori_treatment_in_peptic_ulcer_patients_ L2 - http://www.jidc.org/index.php/journal/article/view/21252448 DB - PRIME DP - Unbound Medicine ER -