Famotidine versus omeprazole, in combination with amoxycillin and tinidazole, for eradication of Helicobacter pylori infection.

Background: Eradication regimens combining two antibiotics with a proton pump inhibitor have been studied intensively. In contrast, only a few studies have focused on the possible role of H2-receptor antagonists in eradication therapy. The mechanism involved in the synergy between antibiotics and pr...

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Publicado en:European Journal of Gastroenterology & Hepatology Vol. 13; no. 8; pp. 921 - 927
Autores principales: Hsu, C C, Chen, J J, Hu, T H, Lu, S N, Changchien, C S
Formato: clinical trial research randomized controlled trial Journal Article
Publicado: Lippincott Williams & Wilkins 2001 Aug
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: European Journal of Gastroenterology & Hepatology
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      dt: 2001 Aug
      vid: 13
      iid: 8
      pid: 5086
      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        138561199
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        10.1097/00042737-200108000-00008
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        138561199
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      tig:
        atl: Famotidine versus omeprazole, in combination with amoxycillin and tinidazole, for eradication of Helicobacter pylori infection.
      aug:
        au:
          Hsu, C C
          Chen, J J
          Hu, T H
          Lu, S N
          Changchien, C S
        affil: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical Centre, Chang Gung Memorial Hospital, Tainan, Taiwan
      sug:
        subj:
          Imidazoles Administration and Dosage
          Penicillins Administration and Dosage
          Famotidine Administration and Dosage
          Helicobacter Pylori
          Amoxicillin Administration and Dosage
          Enzyme Inhibitors Administration and Dosage
          Antibiotics Administration and Dosage
          Omeprazole Administration and Dosage
          Proton Pump Inhibitors
          Helicobacter Infections Drug Therapy
          Histamine H2 Antagonists Administration and Dosage
          Aged, 80 and Over
          Peptic Ulcer Drug Therapy
          Peptic Ulcer Complications
          Human
          Omeprazole Adverse Effects
          Aged
          Adult
          Adolescence
          Helicobacter Infections Complications
          Male
          Penicillins Adverse Effects
          Imidazoles Adverse Effects
          Enzyme Inhibitors Adverse Effects
          Peptic Ulcer Diagnosis
          Female
          Antibiotics Adverse Effects
          Histamine H2 Antagonists Adverse Effects
          Amoxicillin Adverse Effects
          Famotidine Adverse Effects
          Middle Age
          Drug Therapy, Combination
          Helicobacter Infections Diagnosis
          Prospective Studies
          Clinical Trials
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Randomized Controlled Trials
          Impact of Events Scale
          Aged, 80 & over
          Aged: 65+ years
          Adult: 19-44 years
          Adolescent: 13-18 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: Eradication regimens combining two antibiotics with a proton pump inhibitor have been studied intensively. In contrast, only a few studies have focused on the possible role of H2-receptor antagonists in eradication therapy. The mechanism involved in the synergy between antibiotics and proton pump inhibitors is still controversial.Objectives: To compare the results of two triple-therapy regimens, different only in the antisecretory drugs used, in patients with Helicobacter pylori infection, and to assess the impact of primary resistance to metronidazole on treatment outcome.Methods: A total of 120 patients with peptic ulcer and non-ulcer dyspepsia were randomly assigned to a 2-week course of either: famotidine 40 mg twice a day, amoxycillin 1 g twice a day and tinidazole 500 mg twice a day (FAT group; n = 60); or omeprazole 20 mg twice a day, amoxycillin 1 g twice a day and tinidazole 500 mg twice a day (OAT group; n = 60). Upper endoscopy was performed prior to treatment and at least 4 weeks after completion of treatment and discontinuation of the antisecretory therapy. H. pylori status was assessed by a biopsy urease test, histology and culture.Results: In the intention-to-treat analysis, eradication of H. pylori was achieved in 48 of the 60 patients (80%; 95% confidence interval: 70-90%) in the FAT group, compared to 50 of the 60 patients (83.3%; 95% confidence interval: 74-93%) in the OAT group. In the per protocol analysis, eradication therapy was achieved in 48 out of 53 patients (90.6%; 95% confidence interval: 83-98%) treated with FAT and 50 out of 57 patients (87.7%; 95% confidence interval: 79-96%) treated with OAT (not significant). The primary metronidazole resistance was present in 28.8% of strains. Overall, per protocol eradication rates in strains resistant and susceptible to metronidazole were 83.3% and 91.3% respectively (P > 0.05).Conclusions: Two-week courses of either high-dose famotidine or omeprazole, both combined with amoxycillin and tinidazole, are equally effective for eradication of H. pylori infection. In a 2-week triple therapy, metronidazole resistance has no significant impact on eradication rates.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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