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    
Abstract/OtherAbstract:
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.
Authors:
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.
Affiliation:
Gastroenterology Unit, Hospital Parc Taulí, Departament de Medicina, Universitat Autònoma de Barcelona, Sabadell, Spain.
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MeSH Terms
Descriptor/Qualifier:
Aged
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*
Female
Helicobacter Infections / drug therapy*
Helicobacter pylori / drug effects*
Humans
Hydrogen-Ion Concentration
Male
Metronidazole / administration & dosage*
Middle Aged
Chemical
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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