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Bismuth-based quadruple therapy following H. pylori eradication failures: a multicenter study in clinical practice.
- Source :
-
Journal of gastrointestinal and liver diseases : JGLD [J Gastrointestin Liver Dis] 2017 Sep; Vol. 26 (3), pp. 225-229. - Publication Year :
- 2017
-
Abstract
- Background and Aims: Helicobacter pylori (H. pylori) eradication in patients who failed one or more therapeutic attempts remains challenging. This study aimed to assess the efficacy of three-in-one capsules bismuth-based quadruple therapy (Pylera®) in these patients managed in clinical practice.<br />Methods: This was a prospective, open-label, multicenter study enrolling consecutive, adult patients with persistent H. pylori infection following at least one standard therapy. All patients received a rescue quadruple therapy with Pylera (3 capsules four times daily) and esomeprazole 20 mg (1 tablet twice daily) for 10 days. H. pylori eradication was assessed by using Urea Breath Test 4-6 weeks following therapy ending. H. pylori eradication rates, compliance, and side-effects were calculated.<br />Results: A total of 208 patients in the 9 participating centres were enrolled. Overall, 180 patients were successfully cured from the infection, accounting for 86.5% (95% CI 81.9-91.2) and 92.3% (95% CI 88.6-96.1) eradication rates at intention-to-treat analysis and at per protocol analysis, respectively. Cure rates were similar across patients who failed one to three previous therapy attempts, but the success rate fell to 67% after 4 or more therapy failures. Compliance to therapy was good in 198 (95.2%) patients, whilst in 7 (5.3%) cases the therapy was interrupted within 5 days due to side effects. A total of 97 (46.6%) patients complained of at least one side effect; nausea, diarrhea and vomiting were the most frequently reported.<br />Conclusions: Our study found that this bismuth-based quadruple therapy is highly effective as second-line and rescue therapy for H. pylori eradication in clinical practice.
- Subjects :
- Administration, Oral
Adult
Aged
Anti-Bacterial Agents adverse effects
Bismuth adverse effects
Capsules
Drug Administration Schedule
Drug Combinations
Drug Therapy, Combination
Esomeprazole adverse effects
Female
Helicobacter Infections diagnosis
Helicobacter Infections microbiology
Helicobacter pylori pathogenicity
Humans
Intention to Treat Analysis
Italy
Male
Medication Adherence
Metronidazole adverse effects
Middle Aged
Prospective Studies
Proton Pump Inhibitors adverse effects
Remission Induction
Tablets
Tetracycline adverse effects
Time Factors
Treatment Failure
Anti-Bacterial Agents administration & dosage
Bismuth administration & dosage
Esomeprazole administration & dosage
Helicobacter Infections drug therapy
Helicobacter pylori drug effects
Metronidazole administration & dosage
Proton Pump Inhibitors administration & dosage
Tetracycline administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1842-1121
- Volume :
- 26
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of gastrointestinal and liver diseases : JGLD
- Publication Type :
- Academic Journal
- Accession number :
- 28922433
- Full Text :
- https://doi.org/10.15403/jgld.2014.1121.263.zul