Document Detail


Pilot studies to identify the optimum duration of concomitant Helicobacter pylori eradication therapy in Thailand.
MedLine Citation:
PMID:  22759328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM:  Eradication rate for Helicobacter pylori infection with standard triple therapy has globally declined including in Thailand, and new regimens are required that provide reliable high eradication rates. The study was designed to determine whether concomitant therapy administered for either 5 or 10 days would produce a ≥ 95% (grade A) treatment success in H. pylori infected Thai subjects with nonulcer dyspepsia.
METHODS: Two prospective, but separate, pilot single-center studies were carried out during September 2009-December 2010 at Thammasat University Hospital, Thailand. H. pylori infected subjects were randomized into the two pilot studies; either 5-day or 10-day concomitant therapy. Thai concomitant therapy consisted of rabeprazole (20 mg) twice daily, amoxicillin 1 g twice daily, metronidazole 400 mg three times a day, and clarithromycin MR 1 g once daily. H. pylori status was assessed by (13) C-urea breath test 4 weeks after completion of the treatment. Successful treatment was defined as achieving a grade A result (≥ 95%) and failure by <90% cured.
RESULTS: A total of 110 subjects were randomized (55 to the 5-day treatment trial and 55 to the 10-day regimen). Baseline subject demographic and clinical characteristics were similar in both studies. All subjects completed their assigned therapies. The 10-day concomitant treatment trial was successful in 53 of the 55 subjects (96.4%; 95% CI 87.4-99.5%). The 5-day concomitant pilot was judged to be a failure as only 49 of 55 subjects (89.1%; 95% CI = 77.7-95.8%) were cured. The frequency of adverse events was low and similar in the two studies.
CONCLUSION:  The 10-day concomitant regimen provided excellent treatment success (eradication rate >95%) and was well tolerated. Ten-day concomitant therapy is likely to become useful first-line H. pylori eradication in Thailand.
Authors:
Chutima Kongchayanun; Ratha-korn Vilaichone; Bubpha Pornthisarn; Surachai Amornsawadwattana; Varocha Mahachai
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-04-08
Journal Detail:
Title:  Helicobacter     Volume:  17     ISSN:  1523-5378     ISO Abbreviation:  Helicobacter     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-04     Completed Date:  2012-11-01     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  9605411     Medline TA:  Helicobacter     Country:  United States    
Other Details:
Languages:  eng     Pagination:  282-5     Citation Subset:  IM    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
GI Unit, Department of Medicine, Thammasat University Hospital, Pathumthani, Thailand.
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MeSH Terms
Descriptor/Qualifier:
2-Pyridinylmethylsulfinylbenzimidazoles / adverse effects,  therapeutic use
Adult
Aged
Amoxicillin / adverse effects,  therapeutic use
Anti-Bacterial Agents / adverse effects,  therapeutic use*
Clarithromycin / adverse effects,  therapeutic use
Drug Therapy, Combination
Female
Helicobacter Infections / drug therapy*,  epidemiology,  microbiology
Helicobacter pylori / drug effects,  physiology
Humans
Male
Metronidazole / therapeutic use
Middle Aged
Pilot Projects
Prospective Studies
Thailand / epidemiology
Time Factors
Young Adult
Chemical
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Anti-Bacterial Agents; 26787-78-0/Amoxicillin; 32828355LL/rabeprazole; 443-48-1/Metronidazole; 81103-11-9/Clarithromycin

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


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