Sequential Versus Concomitant Therapy for Eradication of Helicobacter Pylori in Patients with Perforated Duodenal Ulcer: A Randomized Trial.

Objectives: Comparison of Helicobacter pylori eradication rates, side effects, compliance, cost, and ulcer recurrence of sequential therapy (ST) with that of concomitant therapy (CT) in patients with perforated duodenal ulcer following simple omental patch closure. Methods: Sixty-eight patients with...

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Publicado en:Saudi Journal of Gastroenterology Vol. 22; no. 4; pp. 309 - 316
Autores principales: Das, Roby, Sureshkumar, Sathasivam, Sreenath, Gubbi S., Kate, Vikram
Formato: research tables/charts Journal Article
Publicado: Wolters Kluwer India Pvt Ltd Jul/Aug2016
Acceso en línea:Ver este registro en EBSCOhost
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        13193767
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      jtl: Saudi Journal of Gastroenterology
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      dt: Jul/Aug2016
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      pub: Wolters Kluwer India Pvt Ltd
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        10.4103/1319-3767.187605
        117335294
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        atl: Sequential Versus Concomitant Therapy for Eradication of Helicobacter Pylori in Patients with Perforated Duodenal Ulcer: A Randomized Trial.
      aug:
        au:
          Das, Roby
          Sureshkumar, Sathasivam
          Sreenath, Gubbi S.
          Kate, Vikram
        affil: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
      sug:
        subj:
          Disease Eradication
          Helicobacter Infections Therapy
          Gastroenterology Care
          Human
          Duodenal Ulcer Complications
          Randomized Controlled Trials
          Patient Compliance
          Health Care Costs
          Duodenal Ulcer Surgery
          Urease
          After Care
          Endoscopy
          Recurrence
          Tomography, X-Ray Computed
          Antibiotics Administration and Dosage
      ab: Objectives: Comparison of Helicobacter pylori eradication rates, side effects, compliance, cost, and ulcer recurrence of sequential therapy (ST) with that of concomitant therapy (CT) in patients with perforated duodenal ulcer following simple omental patch closure. Methods: Sixty-eight patients with perforated duodenal ulcer treated with simple closure and found to be H. pylori positive on three months follow-up were randomized to receive either ST or CT for H. pylori eradication. Urease test and Giemsa stain were used to assess for H. pylori eradication status. Follow-up endoscopies were done after 3 months, 6 months, and 1 year to evaluate the ulcer recurrence. Results: H. pylori eradication rates were similar in ST and CT groups on intention-to-treat (ITT) analysis (71.43% vs 81.80%, P = 0.40). Similar eradication rates were also found in per-protocol (PP) analysis (86.20% vs 90%, P = 0.71). Ulcer recurrence rate in ST groups and CT groups at 3 months (17.14% vs 6.06%, P = 0.26), 6 months (22.86% vs 9.09%, P = 0.19), and at 1 year (25.71 % vs 15.15%, P = 0.37) = follow-up was also similar by ITT analysis. Compliance and side effects to therapies were comparable between the groups. The most common side effects were diarrhoea and metallic taste in ST and CT groups, respectively. A complete course of ST costs Indian Rupees (INR) 570.00, whereas CT costs INR 1080.00. Conclusion: H. pylori eradication rates, side effects, compliance, cost, and ulcer recurrences were similar between the two groups. The ST was more economical compared with CT.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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