Document Detail


Helicobacter pylori and refractory duodenal ulcers: cross-over comparison of continued cimetidine with cimetidine plus antimicrobials.
MedLine Citation:
PMID:  8079928     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the distribution of Helicobacter pylori in the antral and duodenal mucosa of patients with duodenal ulcers refractory to 12 wk of treatment with cimetidine and to evaluate the effect of adding antimicrobial agents to cimetidine on the healing of refractory duodenal ulcers. METHODS: A randomized crossover comparison of continued 800 mg of cimetidine at night for 4 wk with cimetidine plus 500 mg of amoxycillin three times a day for the first 2 wk and 250 mg of metronidazole three times a day for the second 2 wk. H. pylori status in the gastric antral and duodenal mucosa was evaluated by histology and bacterial culture before and at the end of each treatment period. RESULTS: Forty-eight patients were studied. Upon entry to the study, all patients had antral colonization with H. pylori. In the duodenum, active chronic duodenitis was present in 66%, duodenal gastric metaplasia in 33%, and H. pylori in 50%, similar proportions to patients with nonrefractory duodenal ulcers. Healing occurred in 70% (30 of 43) of patients during treatment with cimetidine plus antimicrobials but in only 21% (6 of 28) during treatment with cimetidine alone (p = 0.0003). In patients who received antimicrobials, neither clearance of H. pylori from the antrum (58% of patients) or duodenum (71% of colonized patients) nor eradication of H. pylori (33%) was significantly correlated with ulcer healing. CONCLUSIONS: The distribution of H. pylori in refractory duodenal ulcers is similar to nonrefractory ulcers, and the combination of amoxycillin and metronidazole with cimetidine increases the proportion of refractory duodenal ulcers, which heals.
Authors:
H K Boyd; S Zaterka; J N Eisig; D Chinzon; K Iriya; A A Laudanna; E J Boyd
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  89     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1994 Sep 
Date Detail:
Created Date:  1994-09-30     Completed Date:  1994-09-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1505-10     Citation Subset:  IM    
Affiliation:
Disciplina de Gastroenterologia Clinica, Faculdade de Medicina, Universidade de Sao Paulo, Brasil.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amoxicillin / therapeutic use*
Cimetidine / therapeutic use*
Drug Administration Schedule
Drug Therapy, Combination
Duodenal Ulcer / drug therapy,  epidemiology,  microbiology*
Female
Follow-Up Studies
Helicobacter Infections / drug therapy*,  epidemiology
Helicobacter pylori / isolation & purification*
Humans
Male
Metronidazole / therapeutic use*
Time Factors
Chemical
Reg. No./Substance:
26787-78-0/Amoxicillin; 443-48-1/Metronidazole; 51481-61-9/Cimetidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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