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Low efficacy of clarithromycin including sequential regimens for helicobacter pylori infection.
MedLine Citation:
PMID:  22404442     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background:  Sequential treatment for Helicobacter pylori (H. pylori) appears to achieve a better eradication rate than triple therapy. However, most of the data have been reported from the Italy, and studies from different population are needed before it is recommended in clinical practice. The present study aimed to assess and compare the efficacy of two separate clarithromycin including sequential regimens in Turkey which is well known with high clarithromycin and metronidazole resistance to H. pylori. Methods:  Consecutive H. pylori -positive patients with non-ulcer dyspepsia were randomly allocated to one of the two sequential regimens; the first group was given lansoprazole 30 mg b.i.d. plus amoxicillin 1 g b.i.d. for the first week, followed by lansoprazole 30 mg b.i.d., clarithromycin 500 mg b.i.d., and metronidazole 500 mg t.i.d. for the second week (LA-CM). The second arm was given the same regimen but tetracycline500 g q.i.d. instead of metronidazole (LA-CT). H. pylori was detected with urea breath test (UBT) and histology before enrollment. UBT was repeated at 6th weeks after treatment. Results:  A total of 200 patients were enrolled in groups and 179 of them completed their protocols. The cumulative per protocol ("PP") and intention-to-treat ("ITT") eradication rates were 74.3% and 66.5% in all patients, respectively. Both "PP" (78.2% vs 70.1%) and "ITT" (72% vs 61%) eradication rates were better in LA-CT group than LA-CM group, but the differences were not statistically significant (p > .05). Both regimens were well tolerated, and the incidence of adverse effects was comparable. Conclusion:  Two weeks clarithromycin including sequential regimens with metronidazole or tetracycline were not achieved acceptable eradication rates in Turkey.
Authors:
Abdurrahman Kadayifci; Ahmet Uygun; Guldem Kilciler; Murat Kantarcioglu; Muammer Kara; Ayhan Ozcan; Ozdes Emer
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Helicobacter     Volume:  17     ISSN:  1523-5378     ISO Abbreviation:  Helicobacter     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9605411     Medline TA:  Helicobacter     Country:  United States    
Other Details:
Languages:  eng     Pagination:  121-6     Citation Subset:  IM    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
Department of Gastroenterology, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey Department of Gastroenterology, Gulhane Military Medical Academy, Ankara, Turkey Department of Pathology, Gulhane Military Medical Academy, Ankara, Turkey Department of Nuclear Medicine, Gulhane Military Medical Academy, Ankara, Turkey.
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