| Nonbismuth Quadruple "Concomitant" Therapy Versus Standard Triple Therapy, Both of the Duration of 10 Days, for First-Line H. Pylori Eradication: A Randomized Trial. | |
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MedLine Citation:
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PMID: 22858517 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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GOALS:: To compare the efficacy, compliance, and tolerability of a quadruple, nonbismuth-containing concomitant therapy with standard triple therapy, both of the duration of 10 days, for Helicobacter pylori eradication. BACKGROUND:: Eradication rates obtained with standard therapies are declining as antibiotic resistance becomes more prevalent worldwide. New first-line treatment strategies are needed. STUDY:: Two hundred fifty-seven patients with H. pylori infection were included in the study. Patients were randomized to receive 10-day concomitant therapy comprising esomeprazole 40 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and metronidazole 500 mg, all bid, or 10-day standard triple therapy comprising of esomeprazole 40 mg, amoxicillin 1000 mg, and clarithromycin 500 mg, all bid. Cure rates were defined as a negative C urea breath test 8 weeks after the start of treatment. RESULTS:: Two hundred forty-six patients completed the study. The intention-to-treat cure rates were 90.5% [95% confidence interval (CI): 84.1%-95%] and 73.8% (95%CI, 65.6%-80.7%), whereas the per protocol cure rates were 93.3% (95%CI, 87.2% -97.1%) and 78.5% (95%CI, 70.3%-84.9%), respectively. The eradication rate was significantly higher in the concomitant group compared with the triple therapy group in both the intention-to-treat (P=0.0006) and per protocol (P=0.0014) populations. Adverse events were generally of mild/moderate intensity and did not interfere significantly with compliance, which was excellent for both treatment groups (96.6% and 98.5%, respectively, P=0.44). CONCLUSIONS:: Performance of a 10-day conventional triple regimen is suboptimal. A 10-day concomitant regimen achieved a significantly higher eradication rate and seems to be an effective, safe, and well-tolerated treatment option for H. pylori eradication. |
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Authors:
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Sotirios Georgopoulos; Vasilios Papastergiou; Elias Xirouchakis; Foteini Laoudi; Philipos Lisgos; Charikleia Spiliadi; Nikitas Papantoniou; Stylianos Karatapanis |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-31 |
Journal Detail:
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Title: Journal of clinical gastroenterology Volume: - ISSN: 1539-2031 ISO Abbreviation: J. Clin. Gastroenterol. Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-8-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7910017 Medline TA: J Clin Gastroenterol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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*Gastroenterology Department, Athens Medical, P. Faliron Hospital, Athens †First Department of Internal Medicine, General Hospital of Rhodes ‡Gastroenterology Department, Euromedica General Clinic, Rhodes, Greece. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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