Document Detail


Predictors of failure of Helicobacter pylori eradication with the standard 'Maastricht triple therapy'.
MedLine Citation:
PMID:  11421878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Triple therapy with proton pump inhibitor, clarithromycin and amoxicillin has recently been proposed in Maastricht as first-line treatment for H. pylori infection.
AIM: To determine predictors of unsuccessful eradication.
METHODS: Two hundred and forty-eight patients underwent endoscopy with biopsies for rapid urease test, histology and culture with antibiotic susceptibility tests, and 13C-UBT. All infected patients were given pantoprazole (40 mg b.d.), clarithromycin (500 mg b.d.) and amoxicillin (1 g b.d.) for 1 week. Eradication was assessed by UBT at 4-6 weeks after therapy.
RESULTS: One hundred and sixty-two of 248 patients (65%) were infected. Culture was positive in 144 (89%). Prevalence rates of metronidazole, clarithromycin and amoxicillin resistance were 14, 8 and 3%, respectively. Eradication rates (95% CI) were 63% (54.7-70.6) by intention-to-treat analysis and 67% (59.4-75.4) by per protocol analysis. Drug compliance was excellent and side-effects were mild. Age > or = 45 years (OR: 2.35, CI: 1.30-4.25), smoking (OR: 1.37, CI 1.01-1.87) and high pre-treatment UBT results (OR: 1.36, CI: 1.08-1.72) were independent predictors of eradication failure. Gender, endoscopic findings, alcohol intake, and clarithromycin and amoxicillin resistance did not predict treatment failure.
CONCLUSION: Despite the low prevalence of primary antibiotic resistance in our geographical area, triple therapy with pantoprazole, amoxicillin and clarithromycin achieves low eradication rates. Smoking, age and pre-treatment UBT results are predictors of potential eradication failure.
Authors:
F Perri; M R Villani; V Festa; M Quitadamo; A Andriulli
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  15     ISSN:  0269-2813     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-06-25     Completed Date:  2001-08-09     Revised Date:  2013-06-04    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1023-9     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, 'Casa Sollievo della Sofferenza' Hospital, San Giovanni Rotondo, Italy. perrisgr@tin.it
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MeSH Terms
Descriptor/Qualifier:
2-Pyridinylmethylsulfinylbenzimidazoles
Age Factors
Amoxicillin / pharmacology*
Anti-Bacterial Agents / pharmacology*
Anti-Ulcer Agents / pharmacology*
Benzimidazoles / pharmacology*
Biopsy
Breath Tests
Clarithromycin / pharmacology*
Drug Resistance, Microbial
Drug Therapy, Combination
Endoscopy
Helicobacter Infections / drug therapy*,  pathology
Humans
Omeprazole / analogs & derivatives
Penicillins / pharmacology*
Prospective Studies
Proton Pumps / antagonists & inhibitors*
Risk Factors
Smoking / adverse effects*
Sulfoxides / pharmacology*
Urea / analysis
Chemical
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Anti-Bacterial Agents; 0/Anti-Ulcer Agents; 0/Benzimidazoles; 0/Penicillins; 0/Proton Pumps; 0/Sulfoxides; 26787-78-0/Amoxicillin; 57-13-6/Urea; 73590-58-6/Omeprazole; 81103-11-9/Clarithromycin; D8TST4O562/pantoprazole

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


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