Clarithromycin-resistant genotypes and eradication of Helicobacter pylori.
Background: Three point mutations (A2143G, A2142G, and A2142C) have been involved in Helicobacter pylori clarithromycin resistance.Objective: To compare the eradication rates among the different point mutations and the efficacy of triple therapy and a sequential regimen according to genotypic resist...
| Publicado en: | Annals of Internal Medicine Vol. 144; no. 2; pp. 94 - 101 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | clinical trial research tables/charts Journal Article |
| Publicado: |
American College of Physicians
1/17/2006
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106451450&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106451450 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00034819 AIM jtl: Annals of Internal Medicine issn: 00034819 maglogo: N pubinfo: dt: 1/17/2006 vid: 144 iid: 2 pid: 1652 pub: American College of Physicians place: Philadelphia, Pennsylvania artinfo: ui: 106451450 NLM16418408 2009179012 10.7326/0003-4819-144-2-200601170-00006 NLM16418408 106451450 ppf: 94 ppct: 7 formats: tig: atl: Clarithromycin-resistant genotypes and eradication of Helicobacter pylori. aug: au: De Francesco V Margiotta M Zullo A Hassan C Troiani L Burattini O Stella F Di Leo A Russo F Marangi S Monno R Stoppino V Morini S Panella C Ierardi E De Francesco, Vincenzo Margiotta, Marcella Zullo, Angelo Hassan, Cesare Troiani, Laura affil: Ospedali Riuniti and University of Foggia, Foggia, Italy sug: subj: Amoxicillin Administration and Dosage Clarithromycin Administration and Dosage Drug Resistance, Microbial Genotype Helicobacter Infections Drug Therapy Helicobacter Pylori Helicobacter Pylori Drug Effects Omeprazole Chi Square Test Clinical Trials Data Analysis Software Drug Therapy, Combination Fisher's Exact Test Funding Source Helicobacter Infections Microbiology Hospitals Multivariate Analysis Mutation Random Assignment Secondary Analysis T-Tests Treatment Outcomes Human ab: Background: Three point mutations (A2143G, A2142G, and A2142C) have been involved in Helicobacter pylori clarithromycin resistance.Objective: To compare the eradication rates among the different point mutations and the efficacy of triple therapy and a sequential regimen according to genotypic resistance.Design: Post hoc subgroup study from a multicenter, randomized trial.Setting: Two hospitals in central and southern Italy between January and December 2001.Patients: 156 patients with H. pylori infection.Measurements: Real-time polymerase chain reaction for assessing clarithromycin resistance; histology, rapid urease test, and 13C-urea breath test at entry and after 4 to 6 weeks.Intervention: 7-day triple therapy (20 mg of rabeprazole, 500 mg of clarithromycin, and 1 g of amoxicillin) in 75 patients or a 10-day sequential regimen (20 mg of rabeprazole plus 1 g of amoxicillin for 5 days and 20 mg of rabeprazole, 500 mg of clarithromycin, and 500 mg of tinidazole for the remaining 5 days) in 81 patients. All drugs were given twice daily.Results: Helicobacter pylori infection was eradicated in 11 of 23 patients (48%) with the A2143G mutation and in 14 of 15 patients (93%) with either A2142G or A2142C strains (difference, 45 percentage points [95% CI, 15 to 65 percentage points]; P = 0.004). The sequential regimen achieved a higher cure rate than triple therapy in A2143G mutate strains (difference, 49 percentage points [CI, 8 to 72 percentage points]; P = 0.024).Limitations: The post hoc substudy design may require further confirmation. Other limitations are the accessibility to the tool and the cost of investigations (70 euros per patient).Conclusions: The A2143G mutation seemed to be associated with a very low eradication rate. The sequential regimen achieved a higher cure rate than standard therapy even in patients with these strains. pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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