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Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients.
- Source :
-
Journal of infection in developing countries [J Infect Dev Ctries] 2010 Nov 24; Vol. 4 (11), pp. 712-6. Date of Electronic Publication: 2010 Nov 24. - Publication Year :
- 2010
-
Abstract
- Introduction: The scheme proton pump inhibitor/amoxicillin/clarithromycin (PPI/AC) is still the first-line treatment for Helicobacter pylori (H. pylori) infections despite evidence suggesting its failure in up to 20% to 30% of patients.<br />Methodology: This study involved 493 patients who were prescribed omeprazole (20 mg twice a day) or another proton pump inhibitor in equivalent dosage, amoxicillin (1 g twice a day), and clarithromycin (500 mg twice a day) for seven days. Efficacy was determined by negative urease test and absence of H. pylori on gastric biopsy samples twelve weeks after the end of treatment. Safety was defined according to the adverse effects reported. Mean age of the patients was (± SD) 48.96 ± 13, and demographic and clinical data were recorded for correlation with treatment outcomes.<br />Results: Out of 493 patients, 316 (64.1%) presented duodenal ulcer, 111 (22.5%) gastric ulcer, and 66 (14.4%) simultaneous gastric and duodenal ulcers. Additionally, 267 (54.2%) patients had at least one risk factor for peptic ulcer disease, smoking being the most common (99 [36.5%]). Successful eradication was achieved in 408 patients. The eradication rates per protocol, and according to the intention to treat, were 88.8% and 82.7%, respectively.  Of 164 (35.5%) patients who presented adverse effects, 100 (61%) reported them as mild and only six (3.7%) patients had to discontinue treatment. Previous use of tobacco and non-steroid anti-inflammatory drugs was the only risk factor for treatment failure (P = 0.00).<br />Conclusion: PPI/AC is still a valuable and remarkably tolerable option for first-line H. pylori eradication in Brazil.
- Subjects :
- Adult
Amoxicillin administration & dosage
Amoxicillin adverse effects
Amoxicillin therapeutic use
Anti-Bacterial Agents administration & dosage
Anti-Bacterial Agents adverse effects
Anti-Ulcer Agents administration & dosage
Brazil
Clarithromycin administration & dosage
Clarithromycin adverse effects
Drug Therapy, Combination
Duodenal Ulcer drug therapy
Duodenal Ulcer microbiology
Female
Helicobacter Infections drug therapy
Helicobacter Infections microbiology
Humans
Male
Middle Aged
Omeprazole administration & dosage
Omeprazole adverse effects
Peptic Ulcer microbiology
Proton Pump Inhibitors
Stomach Ulcer drug therapy
Stomach Ulcer microbiology
Treatment Outcome
Anti-Bacterial Agents therapeutic use
Anti-Ulcer Agents therapeutic use
Clarithromycin therapeutic use
Helicobacter pylori drug effects
Omeprazole therapeutic use
Peptic Ulcer drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1972-2680
- Volume :
- 4
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of infection in developing countries
- Publication Type :
- Academic Journal
- Accession number :
- 21252448
- Full Text :
- https://doi.org/10.3855/jidc.911