Document Detail


Randomized comparison of two rescue therapies for Helicobacter pylori infection.
MedLine Citation:
PMID:  17032348     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bismuth salts are not available worldwide. It remains unknown whether clarithromycin can replace bismuth salts as an adjuvant agent in the rescue regimens for Helicobacter pylori infection. We therefore designed the prospective study to compare the efficacies of two rescue therapies for H. pylori infection after standard triple therapies.
PATIENTS AND METHODS: Ninety-three patients who failed H. pylori eradication using proton pump inhibitor plus clarithromycin and amoxicillin were randomly assigned to undergo rescue therapy with esomeprazole, clarithromycin, tetracycline and metronidazole (ECTM group, n = 46) or esomeprazole, bismuth subcitrate, tetracycline and metronidazole (EBTM group, n = 47). Follow-up endoscopy was performed at 8 weeks after the end of treatment to assess the treatment response.
RESULTS: Intention-to-treat analysis demonstrated both groups had similar eradication rates (ECTM 74% vs. EBTM 77%; P = 0.76) and drug compliance (ECTM 94% vs. EBTM 96%; P = 0.68). However, the frequency of adverse events in the ECTM group was higher than that in EBTM group (ECTM 57% vs. EBTM 36%, P = 0.05). In the EBTM group, eradication rate of metronidazole-resistant strains was lower than that of metronidazole-susceptible strains (67%[8/12] vs. 100%[9/9], P = 0.05). However, eradication rates were similar between metronidazole-susceptible and metronidazole-resistant strains in ECTM group (69%[9/13] vs. 70%[7/10], P = 1.00).
CONCLUSIONS: The new ECTM second-line therapy can achieve similar eradication rate as standard EBTM therapy. It may be very useful in countries where bismuth salts are not available.
Authors:
D C Wu; P I Hsu; A Chen; K H Lai; F W Tsay; C J Wu; G H Lo; J Y Wu; I C Wu; W M Wang; H H Tseng
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of clinical investigation     Volume:  36     ISSN:  0014-2972     ISO Abbreviation:  Eur. J. Clin. Invest.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-11     Completed Date:  2007-05-29     Revised Date:  2013-01-07    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  England    
Other Details:
Languages:  eng     Pagination:  803-9     Citation Subset:  IM    
Affiliation:
Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amoxicillin / therapeutic use
Anti-Bacterial Agents / therapeutic use*
Anti-Ulcer Agents / therapeutic use*
Clarithromycin / therapeutic use
Drug Therapy, Combination
Endoscopy, Gastrointestinal
Esomeprazole Sodium / therapeutic use
Female
Helicobacter Infections / drug therapy*
Helicobacter pylori / drug effects,  isolation & purification
Humans
Male
Metronidazole / therapeutic use
Middle Aged
Organometallic Compounds / therapeutic use*
Prospective Studies
Tetracycline / therapeutic use
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Ulcer Agents; 0/Organometallic Compounds; 26787-78-0/Amoxicillin; 443-48-1/Metronidazole; 60-54-8/Tetracycline; 81103-11-9/Clarithromycin; HS813P8QPX/bismuth tripotassium dicitrate; L2C9GWQ43H/Esomeprazole Sodium

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


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