A new quadruple therapy for the eradication of Helicobacter pylori. Effect of pretreatment with omeprazole on the cure rate.
To elucidate whether pretreatment with omeprazole decreases the cure rate of Helicobacter pylori infection with a new quadruple therapy, and thus, whether this pretreatment should not be used in clinical practice, we conducted a randomized trial. Ninety patients with chronic peptic ulcer disease and...
| Publicado en: | Journal of Gastroenterology Vol. 33; no. 5; pp. 640 - 646 |
|---|---|
| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Springer Nature
1998
|
| 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=4690324&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 4690324 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09441174 EJ7 jtl: Journal of Gastroenterology issn: 09441174 maglogo: N pubinfo: dt: 1998 vid: 33 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 4690324 4690324 NLM9773927 4690324 10.1007/s005350050150 NLM9773927 4690324 ppf: 640 ppct: 6 formats: tig: atl: A new quadruple therapy for the eradication of Helicobacter pylori. Effect of pretreatment with omeprazole on the cure rate. aug: au: Okada, Mitsuo Oki, Koichiro Shirotani, Takuro Seo, Mitsuru Okabe, Nobuo Maeda, Kazuhiro Nishimura, Hirokatsu Ohkuma, Kenji Oda, Kazuto Okada, M Oki, K Shirotani, T Seo, M Okabe, N Maeda, K Nishimura, H Ohkuma, K Oda, K affil: First Department of Internal Medicine, School of Medicine, Fukuoka University, Japan sug: subj: Helicobacter Pylori Drug Effects Drug Therapy, Combination Dyspepsia Drug Therapy Helicobacter Infections Drug Therapy Omeprazole Therapeutic Use Gastrointestinal Agents Therapeutic Use Peptic Ulcer Drug Therapy Omeprazole Adverse Effects Antibiotics Therapeutic Use Treatment Outcomes Male Amoxicillin Therapeutic Use Helicobacter Infections Complications Aged Dyspepsia Microbiology Human Metronidazole Therapeutic Use Erythromycin Therapeutic Use Helicobacter Pylori Peptic Ulcer Microbiology Adult Gastrointestinal Agents Adverse Effects Female Middle Age Penicillins Therapeutic Use Randomized Controlled Trials Random Assignment Aged: 65+ years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: To elucidate whether pretreatment with omeprazole decreases the cure rate of Helicobacter pylori infection with a new quadruple therapy, and thus, whether this pretreatment should not be used in clinical practice, we conducted a randomized trial. Ninety patients with chronic peptic ulcer disease and nonulcer dyspepsia, with biopsy-proven H. pylori infection were randomly assigned to the two following regimens: Group 1 (n = 45) received omeprazole 20 mg once daily for 2 weeks (days 1-14), and 500 mg amoxicillin granules and 250 mg metronidazole thrice daily, and roxithromycin 150 mg twice daily for 1 week (days 8-14), Group 2 (n = 45) received the same antibiotic treatment as group 1 for 1 week (days 1-7), in addition to omeprazole treatment for 2 weeks (days 1-14). Four weeks after the treatment ended, endoscopy was repeated, with two biopsy specimens each taken from the antrum and the corpus (total of four specimens) for a urease test, histological analysis, and culture to establish cure of infection. A patient was regarded as cured only if all three methods gave negative results for H. pylori. In the intention-to-treat analysis, 42 of 45 patients (93.3%; 95% confidence intervals [CI], 81.7%-98.6%) in group 1 were cured compared with 43 of 45 patients (95.6%; 95% CI, 84.9%-99.5%) in group 2. In the per-protocol analysis, the corresponding figures were 42/44 (95.5%; 95% CI 84.5%-99.4%) and 43/44 (97.7%; 95% CI, 88.0%-99.9%). There were no significant differences in the cure rate between the two groups on either analysis. All patients, except for one who had an allergic reaction, completed the treatment regimens. Fifty to sixty percent of the patients had no side effects while the rest had mild to moderate side effects. The new quadruple therapy consisting of omeprazole, amoxicillin, metronidazole, and roxithromycin appears suitable for use in clinical practice, as the cure rate was 95% and no severe side effects were observed. Pretreatment with omeprazole did not reduce the cure rate for this new quadruple therapy. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|