Document Detail


One-week therapy for Helicobacter pylori. A randomized trial of two treatment regimens.
MedLine Citation:
PMID:  8899495     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In clinical practice, eradication of Helicobacter pylori infection may be difficult due to medication side effects and the need for 2 weeks of therapy. Because therapies of shorter duration may improve patient compliance and reduce treatment side effects, we compared the efficacy and tolerability of two anti-H. pylori treatments of 1 week's duration. Patients with H. pylori infection were randomized to treatment with either (a) short-course triple therapy, composed-of bismuth subsalicylate (Pepto-Bismol, Procter & Gamble, Cincinnati, OH, U.S.A.) two tablets four times daily, amoxicillin 1 g (two 500-mg tablets) twice daily, and metronidazole 500 mg four times daily on days 5-7 or (b) omeprazole 40 mg twice a day with amoxicillin 1 g twice a day for 1 week. At least 4 weeks posttreatment, efficacy was evaluated with either histological evaluation of antral biopsies for H. pylori or 14C urea breath testing. Patients who failed initial therapy were allowed to cross over to the alternative treatment regimen after a minimum "wash-out" period of 5 weeks. Patients completed a diary during therapy to monitor both compliance and side effects. Thirty-four patients completed the study, 10 receiving both treatment regimens. Treatment with the shortcourse triple therapy eradicated H. pylori in 78.3% of treatments compared with 38% with the high-dose omeprazole/ amoxicillin combination (p < 0.05). Patients were highly compliant with both treatments, and mild side effects, such as transient loose stools or abdominal pain, were common in both groups. This is the first report from North America confirming the success of the short-course triple therapy for the eradication of H. pylori. The high-dose omeprazole/ amoxicillin regimen's eradication rate was markedly inferior to that achieved by the short-course triple therapy regimen and should not be used. Comparative studies of the short-course triple therapy regimen with other 7-day anti-H. pylori treatment regimen therapies are indicated.
Authors:
J M Scheiman; W D Chey; E M Behler; I Crause; G H Elta
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  23     ISSN:  0192-0790     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1997-01-28     Completed Date:  1997-01-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  170-3     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA.
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MeSH Terms
Descriptor/Qualifier:
Amoxicillin / administration & dosage*
Anti-Ulcer Agents / administration & dosage*
Bismuth / administration & dosage*
Drug Administration Schedule
Drug Therapy, Combination
Female
Helicobacter Infections / drug therapy*
Helicobacter pylori*
Humans
Male
Metronidazole / administration & dosage*
Middle Aged
Omeprazole / administration & dosage*
Organometallic Compounds / administration & dosage*
Penicillins / administration & dosage*
Salicylates / administration & dosage*
Chemical
Reg. No./Substance:
0/Anti-Ulcer Agents; 0/Organometallic Compounds; 0/Penicillins; 0/Salicylates; 14882-18-9/bismuth subsalicylate; 26787-78-0/Amoxicillin; 443-48-1/Metronidazole; 73590-58-6/Omeprazole; 7440-69-9/Bismuth

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


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