Document Detail

High-dose, ten-day esomeprazole, amoxicillin and metronidazole triple therapy achieves high Helicobacter pylori eradication rates.
MedLine Citation:
PMID:  22591220     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Strong acid inhibition using esomeprazole increases cure rates with triple therapy and 10-day treatments are more effective than 7-day ones. The combination of amoxicillin plus metronidazole at full doses, and using a physiologically-correct schedule three times a day, and has been shown to overcome metronidazole resistance and to achieve good eradication rates.
AIMS: To assess the eradication rate of a new first-line treatment regimen associating strong acid inhibition, amoxicillin and metronidazole and to evaluate tolerance.
METHODS: Patients from eight hospitals were included. Helicobacter pylori status was assessed by at least one of the following: histology, culture, rapid urease test or urea breath test (UBT). Ten-day treatment was prescribed comprising esomeprazole 40 mg twice a day plus amoxicillin 1 g and metronidazol 500 mg both three times a day. Helicobacter pylori cure was assessed by UBT.
RESULTS: A hundred and thirty-six patients were enrolled. Mean age was 52.6 ± 16 years and 59.6% of patients were men. Main indications for treatment were: uninvestigated dyspepsia (13.6%); functional dyspepsia (18.2%); gastric ulcer (21.8%); and duodenal ulcer (39.8%). Helicobacter pylori eradication was achieved in 112 of the 127 patients who returned for follow-up. Eradication rates were 82.4% (95% CI: 74.7-88.1) by intention-to-treat analysis and 88.2% (95% CI: 81.2-92.8) by per protocol. Treatment was well tolerated and no major side effects were reported. Nine patients complained of mild side effects.
CONCLUSIONS: Cure rates of the combination of esomeprazole, amoxicillin and metronidazole are high and the treatment was well tolerated. This pilot study warrants the comparison of this schedule with current standards.
J Sánchez-Delgado; P García-Iglesias; M Castro-Fernández; F Bory; M Barenys; L Bujanda; J Lisozain; M M Calvo; S Torra; J P Gisbert; X Calvet
Publication Detail:
Type:  Journal Article     Date:  2012-05-17
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  36     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-18     Completed Date:  2012-11-01     Revised Date:  2013-01-07    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  190-6     Citation Subset:  IM    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Gastroenterology Unit, Hospital Parc Taulí, Departament de Medicina, Universitat Autònoma de Barcelona, Sabadell, Spain.
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MeSH Terms
Amoxicillin / administration & dosage*
Anti-Infective Agents / administration & dosage*
Anti-Ulcer Agents / administration & dosage*
Breath Tests
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Esomeprazole Sodium / administration & dosage*
Helicobacter Infections / drug therapy*
Helicobacter pylori / drug effects*
Hydrogen-Ion Concentration
Metronidazole / administration & dosage*
Middle Aged
Reg. No./Substance:
0/Anti-Infective Agents; 0/Anti-Ulcer Agents; 26787-78-0/Amoxicillin; 443-48-1/Metronidazole; L2C9GWQ43H/Esomeprazole Sodium

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

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