The outcome of a 2-week treatment of Helicobacter pylori-positive duodenal ulcer with omeprazole-based antibiotic regimen in a region with high metronidazole resistance rate.
Background/objective: Metronidazole resistance is a major problem in many developing countries. Our main objective was to study the outcome of a non-metronidazole and omeprazole-based antibiotic regimen in eradicating Helicobacter pylori in patients with duodenal ulcer.Design: A prospective study of...
| Publicado en: | European Journal of Gastroenterology & Hepatology Vol. 11; no. 11; pp. 1259 - 1264 |
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| Autores principales: | , , , , , , , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Nov1999
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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=110640126&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 110640126 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0954691X 8CE jtl: European Journal of Gastroenterology & Hepatology issn: 0954691X maglogo: N pubinfo: dt: Nov1999 vid: 11 iid: 11 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 110640126 110640126 NLM10563537 110640126 10.1097/00042737-199911000-00013 NLM10563537 110640126 ppf: 1259 ppct: 5 formats: tig: atl: The outcome of a 2-week treatment of Helicobacter pylori-positive duodenal ulcer with omeprazole-based antibiotic regimen in a region with high metronidazole resistance rate. aug: au: Adeyemi, Edward O. Danial, Moheb F. Helal, Thanaa Benedict, Sheela Abdulle, Abdishakur M. Adeyemi, E O Danial, M F Helal, T Benedict, S Abdulle, A M affil: Department of Internal Medicine, Faculty of Medicine and Health Sciences, UAE University, P O Box 17666, Al Ain, United Arab Emirates, and bThe Department of Pathology, Al Ain Hospital, Al Ain, United Arab Emirates sug: subj: Duodenal Ulcer Drug Therapy Omeprazole Therapeutic Use Helicobacter Pylori Drug Effects Helicobacter Infections Drug Therapy Antibiotics Therapeutic Use Biopsy Duodenal Ulcer Pathology Treatment Outcomes Prospective Studies Male Omeprazole Adverse Effects Middle Age Amoxicillin Adverse Effects Duodenal Ulcer Microbiology Metronidazole Clarithromycin Adverse Effects Helicobacter Pylori Drug Resistance, Microbial Female Human Adult Clarithromycin Therapeutic Use Antibiotics Adverse Effects Amoxicillin Therapeutic Use Adolescence Clinical Trials Validation Studies Comparative Studies Evaluation Research Multicenter Studies Middle Aged: 45-64 years Adult: 19-44 years Adolescent: 13-18 years Male Female ab: Background/objective: Metronidazole resistance is a major problem in many developing countries. Our main objective was to study the outcome of a non-metronidazole and omeprazole-based antibiotic regimen in eradicating Helicobacter pylori in patients with duodenal ulcer.Design: A prospective study of 50 consecutive patients with proven peptic ulcer (mean age 36.6 +/- 10.5 years, range 17-60, male:female = 2), referred from the primary health centres.Main Outcome Measure: The primary outcome of the study was H. pylori eradication, at least 4 weeks after stopping antibiotic treatment.Methods: Patients were considered eligible for the study if they had endoscopic evidence or a past medical history of peptic ulcer and had not received any antibiotics for at least 4 weeks prior to admission into the study. H. pylori infection was confirmed by serology, histology, a rapid urease test (RUT) and culture. After an initial oesophago-gastroduodenoscopy (OGD), each patient received a 2-week course of omeprazole (20 mg twice daily), and each of amoxycillin capsules (500 mg) and clarithromycin tablets (250 mg) thrice daily after food. The follow-up OGDs were performed after a mean period of 10.04 weeks (range 4-48) and at 10.4 +/- 2.5 months (range 6-14 months) after stopping treatment.Results: All 50 patients completed the study. The sensitivity values for serology, RUT and histopathology were 98, 96 and 100%, respectively. H. pylori culture was positive in only 15 of 50 patients (30% sensitivity). H. pylori was eradicated in 47 (94%) patients. There was no evidence of H. pylori infection in the 27 of 35 (77%) patients, who returned for a third OGD. At the time of the second OGD, there was a significant reduction of pain-days (from 5.47 to 1.16), and antral (from 1.95 to 0.78) and corpus (from 1.8 to 0.6) mucosal cellular infiltrate scores, when compared with the first OGD (P < 0.001 in each case).Conclusion: Exclusion of metronidazole from the treatment regimen of patients with H. pylori-positive duodenal ulcer in a region with metronidazole resistance yielded an excellent H. pylori eradication rate of 94%, when omeprazole, amoxicillin and clarithromycin were used. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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