Effect of two different doses of metronidazole and tetracycline in bismuth triple therapy on eradication of Helicobacter pylori and its resistant strains.
Background: Classic triple therapy with bismuth, tetracycline and metronidazole is one of the most economic and effective regimens for the eradication of Helicobacter pylori. The aim of the study was to assess the efficacy of two different doses of tetracycline (TET) and metronidazole (MET) on cure...
| Publicado en: | European Journal of Gastroenterology & Hepatology Vol. 11; no. 7; pp. 709 - 713 |
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| Autores principales: | , , , , |
| Formato: | clinical trial research randomized controlled trial Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Jul1999
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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=110640249&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 110640249 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0954691X 8CE jtl: European Journal of Gastroenterology & Hepatology issn: 0954691X maglogo: N pubinfo: dt: Jul1999 vid: 11 iid: 7 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 110640249 110640249 NLM10445787 110640249 10.1097/00042737-199907000-00004 NLM10445787 110640249 ppf: 709 ppct: 4 formats: tig: atl: Effect of two different doses of metronidazole and tetracycline in bismuth triple therapy on eradication of Helicobacter pylori and its resistant strains. aug: au: Roghani, H. Salman Massarrat, S. Pahlewanzadeh, M. R. Dashti, M. Roghani, H S affil: Departments of aInternal Medicine, bMicrobiology and cPathology, Yazd University of Medical Sciences, Yazd, Iran, and dDepartment of Gastroenterology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran sug: subj: Antacids Therapeutic Use Antibiotics Administration and Dosage Helicobacter Pylori Antibiotics Therapeutic Use Helicobacter Infections Drug Therapy Metronidazole Administration and Dosage Bismuth Therapeutic Use Tetracycline Therapeutic Use Male Adult Human Treatment Outcomes Metronidazole Therapeutic Use Female Middle Age Clinical Trials Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Interview Guides Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Background: Classic triple therapy with bismuth, tetracycline and metronidazole is one of the most economic and effective regimens for the eradication of Helicobacter pylori. The aim of the study was to assess the efficacy of two different doses of tetracycline (TET) and metronidazole (MET) on cure of H. pylori infection and its MET-resistant strains.Material and Methods: A total of 131 patients with duodenal ulcer were randomized into three groups and received the following medication for 2 weeks: group A, colloidal bismuth subcitrate (CBS) 3 x 120 mg + TET 3 x 500 mg + MET 3 x 250 mg/day; group B, CBS 3 x 120 mg + TET 3 x 500 mg + MET 3 x 125 mg/day; group C, CBS 3 x 120 mg + TET 3 x 250 mg + MET 3 x 125 mg/day. Control endoscopy was performed after 6 weeks. Two biopsy specimens from antral and three from corpus mucosa were taken for a urease test, histology and culture. Eradication was concluded if all three tests were negative for H. pylori. MET resistance was determined by the disc diffusion method.Results: In total, 121 patients completed the study. Only two of the 43 patients in group A discontinued the therapy due to intolerance. Cure of H. pylori infection was achieved by per protocol analysis in 33 of 43 patients in group A (76.7%), in 20 of 40 patients in group B (50%) and in 20 of 38 patients in group C (52.6%) (P < 0.05 for A versus B or C). Forty-two out of 112 patients had H. pylori strains resistant to MET (42%). In each group, the cure rate of infection was higher in patients with MET-sensitive H. pylori than in MET-resistant H. pylori (80.7% versus 64.2% in group A, 60% versus 38.8% in group B and 52.6% versus 40% in group C, respectively). Increase of MET dose from 375 mg (in groups B and C) to 750 mg/day (in group A) seems to augment the eradication of MET-sensitive as well as MET-resistant strains (up from 52% to 84% and from 39% to 64%, respectively; P < 0.05).Conclusion: Cure rate of H. pylori infection under classic triple therapy remains unaffected by dose reduction of tetracycline but not of metronidazole. In countries with a high prevalence of metronidazole resistance, such as Iran, higher doses of metronidazole are probably needed to increase the cure rate of bismuth triple therapy. pubtype: Academic Journal doctype: clinical trial research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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