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Efficacy of Reduced Dosage of Amoxicillin in an Eradication Therapy for Helicobacter pylori Infection in Patients on Hemodialysis: A Randomized Controlled Trial.
- Source :
-
Digestion [Digestion] 2018; Vol. 97 (2), pp. 163-169. Date of Electronic Publication: 2018 Jan 08. - Publication Year :
- 2018
-
Abstract
- Background: An optimum Helicobacter pylori-eradication regimen for hemodialysis patients is yet to be established because of different pharmacokinetics of amoxicillin involved between hemodialysis patients and healthy subjects. We investigated to establish appropriate doses of amoxicillin for H. pylori infection eradication in hemodialysis patients.<br />Methods: Of 409 hemodialysis patients screened for H. pylori infection, 37 H. pylori-positive patients were randomized to different 1-week eradication regimens: esomeprazole 20 mg twice a day (b.i.d.) and clarithromycin 200 mg b.i.d., plus amoxicillin at either 750 mg b.i.d. (group A; conventional) or 250 mg b.i.d. (group B; experimental). Sixty-three patients with normal renal function received the conventional regimen (group C). Successful eradication was confirmed by urea breath testing.<br />Results: Eradication rates of group B (reduced amoxicillin-regimen) were 84.2% in intention-to-treat analysis and 88.9% in per-protocol analysis, which were similar with group A (77.8 and 77.8%) and group C (74.6 and 81.0%). However, the incidence of adverse events in group A was significantly higher than that in group C (22.2 vs. 5.1%, p = 0.027).<br />Conclusions: In H. pylori-positive hemodialysis patients, amoxicillin at 250 mg b.i.d. may be an appropriate scheme for eradication with equivalent effects to the conventional therapy and safety effects for adverse events.<br /> (© 2018 S. Karger AG, Basel.)
- Subjects :
- Aged
Amoxicillin therapeutic use
Anti-Bacterial Agents therapeutic use
Anti-Ulcer Agents therapeutic use
Breath Tests
Clarithromycin therapeutic use
Dose-Response Relationship, Drug
Drug Therapy, Combination methods
Esomeprazole therapeutic use
Female
Helicobacter Infections epidemiology
Helicobacter Infections microbiology
Helicobacter pylori isolation & purification
Humans
Japan epidemiology
Levofloxacin therapeutic use
Male
Middle Aged
Prevalence
Treatment Outcome
Amoxicillin administration & dosage
Anti-Bacterial Agents administration & dosage
Helicobacter Infections drug therapy
Helicobacter pylori drug effects
Renal Dialysis adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9867
- Volume :
- 97
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Digestion
- Publication Type :
- Academic Journal
- Accession number :
- 29310119
- Full Text :
- https://doi.org/10.1159/000484981