scholarly journals Helicobacter pyloriEradication with Either Seven-Day or 10-Day Triple Therapies, and with a 10-Day Sequential Regimen

2006 ◽  
Vol 20 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Giuseppe Scaccianoce ◽  
Cesare Hassan ◽  
Alba Panarese ◽  
Donato Piglionica ◽  
Sergio Morini ◽  
...  
Keyword(s):  
Triple Therapy ◽  
Breath Test ◽  
Eradication Rate ◽  
Urea Breath Test ◽  
Cure Rate ◽  
Intention To Treat ◽  
Significant Difference ◽  
Sequential Regimen ◽  
H Pylori ◽  
Very High

BACKGROUND:Helicobacter pylorieradication rates achieved by standard seven-day triple therapies are decreasing in several countries, while a novel 10-day sequential regimen has achieved a very high success rate. A longer 10-day triple therapy, similar to the sequential regimen, was tested to see whether it could achieve a better infection cure rate.METHODS: Patients with nonulcer dyspepsia andH pyloriinfection were randomly assigned to one of the following three therapies: esomeprazole 20 mg, clarithromycin 500 mg and amoxycillin 1 g for seven days or 10 days, or a 10-day sequential regimen including esomeprazole 20 mg plus amoxycillin 1 g for five days and esomeprazole 20 mg, clarithromycin 500 mg and tinidazole 500 mg for the remaining five days. All drugs were given twice daily.H pylorieradication was checked four to six weeks after treatment by using a13C-urea breath test.RESULTS: Overall, 213 patients were enrolled.H pylorieradication was achieved in 75.7% and 77.9%, in 81.7% and 84.1%, and in 94.4% and 97.1% of patients following seven-day or 10-day triple therapy and the 10-day sequential regimen, at intention-to-treat and per protocol analyses, respectively. The eradication rate following the sequential regimen was higher than either seven-day (P=0.002) or 10-day triple therapy (P=0.02), while no significant difference emerged between the latter two regimens (P=0.6).CONCLUSIONS: The 10-day sequential regimen was significantly more effective than both triple regimens, while 10-day triple therapy failed to significantly increase theH pylorieradication rate achieved by the standard seven-day regimen.

scholarly journals Efficacy of dexlansoprazole-based triple therapy for Helicobacter pylori infections

2019 ◽  
Vol 12 ◽  
pp. 175628481987096
Author(s):  
Chia-Jung Kuo ◽  
Chun-Wei Chen ◽  
Puo-Hsien Le ◽  
Jun-Te Hsu ◽  
Cheng-Yu Lin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Breath Test ◽  
Eradication Rate ◽  
Urea Breath Test ◽  
Helicobacter Pylori Eradication ◽  
Treatment Regimens ◽  
Group A ◽  
H Pylori ◽  
Group B

Background: Dexlansoprazole has been shown to be efficacious for the treatment of gastroesophageal reflux disease. However, there is a paucity of data about its efficacy for Helicobacter pylori eradication. The aim of this study was to evaluate the efficacy of dexlansoprazole for H. pylori eradication as triple therapy in real-world practice. Methods: Adult patients with endoscopically proven H. pylori related peptic ulcer diseases or gastritis were recruited for this study. The eradication status was assessed based on the results of the 13C-urea breath test performed 4 weeks after treatment. According to the different treatment regimens, the patients were allocated to group A: Esomeprazole 40 mg b.i.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 days; group B: Esomeprazole 40 mg q.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 days, or group C: Dexlansoprazole 60 mg q.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 days. Results: A total of 215 patients (49% males) were enrolled in this study, with a mean age of 55 years. The eradication rates in group A, B, and C were 94.7% (71/75), 89.6% (69/77), and 93.7% (59/63) ( p = 0.457), respectively. The adverse events were similar between the three groups ( p = 0.068). Conclusions: This study suggests that dexlansoprazole-based triple therapy has an acceptable eradication rate for H. pylori infection.

Dual Therapy with Vonoprazan and Amoxicillin Is as Effective as Triple Therapy with Vonoprazan, Amoxicillin and Clarithromycin for Eradication of Helicobacter pylori

Digestion ◽  
2019 ◽  
Vol 101 (6) ◽  
pp. 743-751 ◽  
Author(s):  
Takahisa Furuta ◽  
Mihoko Yamade ◽  
Takuma Kagami ◽  
Takahiro Uotani ◽  
Takahiro Suzuki ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Antimicrobial Agents ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
Urea Breath Test ◽  
Intention To Treat ◽  
H Pylori ◽  
Treat Analysis

<b><i>Backgrounds/Aims:</i></b> Vonoprazan (VPZ) is the first clinically available potassium competitive acid blocker. This class of agents provides faster and more potent acid inhibition than proton pump inhibitors. Most strains of <i>Helicobacter pylori</i> are sensitive to amoxicillin. We hypothesized that dual therapy with VPZ and amoxicillin would provide the sufficient eradication rate for <i>H. pylori</i> infection. To evaluate this, we compared the eradication rate by the dual VPZ/amoxicillin therapy with that by the standard triple VPZ/amoxicillin/clarithromycin therapy. <b><i>Methods:</i></b> Non-inferiority of the eradication rate of <i>H. pylori</i> by the dual therapy with VPZ 20 mg twice daily (bid) and amoxicillin 500 mg 3 times daily (tid) for 1 week to that by the triple therapy with VPZ 20 mg bid, amoxicillin 750 mg bid and clarithromycin 200 mg bid for 1 week was retrospectively studied. Propensity score matching was performed to improve comparability between 2 regimen groups. Successful eradication was diagnosed using the [<sup>13</sup>C]-urea breath test at 1–2 months after the end of eradication therapy. <b><i>Results:</i></b> The intention-to-treat analysis demonstrated that the eradication rate by the dual therapy (92.9%; 95% CI 82.7–98.0%, 52/56) was not inferior to that of the triple therapy (91.9%; 95% CI 80.4–97.0%, 51/56; OR 1.275, 95% CI 0.324–5.017%, <i>p</i> = 0.728). There were no statistically significant differences in incidences of adverse events between 2 regimens. <b><i>Conclusion:</i></b> VPZ-based dual therapy (VPZ 20 mg bid and amoxicillin 500 mg tid for 1 week) provides an acceptable eradication rate of <i>H. pylori</i> infection without the need for second antimicrobial agents, such as clarithromycin.

scholarly journals 7-Day Nonbismuth-Containing Concomitant Therapy Achieves a High Eradication Rate forHelicobacter pyloriin Taiwan

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Sung-Shuo Kao ◽  
Wen-Chi Chen ◽  
Ping-I Hsu ◽  
Kwok-Hung Lai ◽  
Hsien-Chung Yu ◽  
...  
Keyword(s):  
Eradication Rate ◽  
Compliance Rate ◽  
Eradication Therapy ◽  
Urea Breath Test ◽  
Concomitant Therapy ◽  
Drug Compliance ◽  
Clinical Factor ◽  
Intention To Treat ◽  
H Pylori ◽  
Very High

Background.Ten-day concomitant therapy achieves a high eradication rate in Taiwan. Whether shortening the duration of concomitant therapy can still keep a high eradication rate remains unclear.Aim.To assess the eradication rate of 7-day pantoprazole-containing concomitant therapy in Taiwan and to investigate factors influencing the eradication outcome.Methods.From March 2008 to March 2012, 319H. pylori-infected patients receiving a 7-day pantoprazole-containing concomitant regimen (pantoprazole 40 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily for 7 days) were included. Patients were asked to return at the second week to assess drug compliance and adverse effects. Repeated endoscopy or urea breath test was performed at 8 weeks after the end of eradication therapy.Results.The eradication rates according to intention-to-treat and per-protocol analyses were 93.7% (299/319) and 96.4% (297/308), respectively. Adverse events occurred in 13.2% (42/319) of the patients. The compliance rate was 98.4% (314/319). Multivariate analysis disclosed that poor compliance was the only independent factor influencing the efficacy of anti-H. pyloritherapy with an odds ratio of 0.073 (95% confidence interval, 0.011–0.483).Conclusion.7-day concomitant therapy achieved a very high eradication rate forH. pyloriinfection in Taiwan. Drug compliance was the only clinical factor influencing treatment efficacy.

scholarly journals A 14-Day Course of Triple Therapy is Superior to a 10-Day Course for the Eradication ofHelicobacter pylori: A Canadian Study Conducted in a ‘Real World’ Setting

2015 ◽  
Vol 29 (8) ◽  
pp. e7-e10 ◽  
Author(s):  
Yen-I Chen ◽  
Carlo A Fallone
Keyword(s):  
Triple Therapy ◽  
Eradication Rate ◽  
Day Treatment ◽  
Office Visit ◽  
First Line ◽  
Intention To Treat ◽  
Treatment Naïve ◽  
Gastric Biopsies ◽  
H Pylori ◽  
Treat Analysis

BACKGROUND: SuccessfulHelicobacter pylorieradication with the traditional seven-day course of proton pump inhibitor (PPI) triple therapy is declining. Prolonging therapy to either 10 or 14 days is associated with better eradications rates.OBJECTIVE: To compare the effectiveness of 14-day course of triple therapy versus a 10-day course in the treatment ofH pyloriin Canada.METHODS: Consecutive treatment-naive patients with clinical indications forH pylorieradication underwent either a 10-day course or a 14-day course of traditional PPI triple therapy depending on the date of the office visit (an odd date received the 10-day course, whereas an even date received the 14-day treatment).H pylorieradication was ascertained via urea breath test or gastric biopsies performed ≥4 weeks after completion of therapy. Analyses were by both intention to treat and per-protocol.RESULTS: A total of 83 patients were included in the study (31 in the 10-day group and 52 in the 14-day group). In the intention-to-treat analysis, eradication rates were 82.7% (95% CI 70% to 92%) versus 45.2% (95% CI 27% to 64%), favouring the 14-day treatment (P<0.001). Similarly, in the per-protocol analysis, eradication rates were 91.5% (95% CI 80% to 98%) versus 63.6% (95% CI 41% to 83%), favouring the 14-day arm (P=0.01). Adverse events and compliance were not significantly different between the two groups.CONCLUSION: A 14-day course of standard PPI triple therapy was superior to a shorter-duration therapy and should be included as a first-line regimen forH pylorieradication in Canada. The 10-day course of treatment did not achieve an acceptable eradication rate and should no longer be used in this country.

Eradication Rate of H. pylori After Therapy Based on Urea Breath Test: A Single-Center Study on the U.S.-Mexico Border

2016 ◽  
Vol 111 ◽  
pp. S498
Author(s):  
Roy Liu ◽  
Roberta Romero ◽  
Jerzy Sarosiek ◽  
Alok Dwivedi ◽  
Christopher Dodoo ◽  
...  
Keyword(s):  
Breath Test ◽  
Eradication Rate ◽  
Urea Breath Test ◽  
Single Center ◽  
Single Center Study ◽  
Mexico Border ◽  
H Pylori ◽  
The U.S ◽  
Center Study

scholarly journals Efficacy of Levofloxacin Based Triple and High-Dose PPI-Amoxicillin Dual Eradication Therapy for Helicobacter pylori after Failures of First- and Second-Line Therapies

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Kenichiro Okimoto ◽  
Makoto Arai ◽  
Keiko Saito ◽  
Shoko Minemura ◽  
Daisuke Maruoka ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Eradication Therapy ◽  
High Dose ◽  
Second Line ◽  
Intention To Treat ◽  
The Third ◽  
Significant Difference ◽  
Third Line

Objectives. The aim of this study was to investigate and compare the eradication rate of Helicobacter pylori as the third-line triple therapy with rabeprazole (RPZ) + amoxicillin (AMPC) + levofloxacin (LVFX) and high-dose RPZ + AMPC. Methods. 51 patients who failed Japanese first-line (proton pump inhibitor (PPI) + AMPC + clarithromycin) and second-line (PPI + AMPC + metronidazole) eradication therapy were randomly assigned at a 1 : 1 ratio to one of the following third-line eradication groups: (1) RAL group: RPZ 10 mg (b.i.d.), AMPC 750 mg (b.i.d.), and LVFX 500 mg (o.d.) for 10 days; (2) RA group: RPZ 10 mg (q.i.d.) and AMPC 500 mg (q.i.d.) for 14 days. Patients who failed to respond to third-line eradication therapy received salvage therapy. Results. The rates of eradication success, based on intention to treat (ITT) analysis, were 45.8% in the RAL group and 40.7% in the RA group. The overall eradication rates were 73.9% in the RAL group and 64.0% in the RA group. There was no significant difference between the two groups. Conclusions. The third-line triple therapy with RPZ, AMPC, and LVFX was as effective as that with high-dose RPZ and AMPC.

Eradication Rates in Italian Subjects Heterogeneously Managed for Helicobacter pylori Infection. Time to Abandon Empiric Treatments in Southern Europe

2017 ◽  
Vol 26 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Agostino Di Ciaula ◽  
Giuseppe Scaccianoce ◽  
Marino Venerito ◽  
Angelo Zullo ◽  
Leonilde Bonfrate ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Breath Test ◽  
Eradication Rate ◽  
Real Life ◽  
Sequential Therapy ◽  
Urea Breath Test ◽  
Southern Europe ◽  
Clarithromycin Resistance ◽  
Asymptomatic Patients ◽  
H Pylori

Background & Aims: H. pylori eradication is strongly affected by various factors, including the ongoing antibiotic resistance. We describe a “real life” scenario in patients managed for H. pylori-related conditions, living in a southern Italian region (Apulia), an area with clarithromycin resistance >15%.Methods: 2,224 subjects were studied in two tertiary referral centers in Apulia. Analyses included: reason for referral, H. pylori infection rates (13C-urea breath test – UBT or upper endoscopy), and eradication rates following distinct regimens previously prescribed or prospectively prescribed (such as the bismuth-based quadruple therapy Pylera®, recently marketed in Italy).Results. Over 80% of the patients were referred by family physicians (60% naïve subjects). The overall infection rate was 32.5% and it was similar in asymptomatic patients (31.1%) or with H. pylori-related symptoms/clinical conditions (34.3%). In the 987 H. pylori+ve patients receiving therapy, the overall eradication rate was 80.2% (ITT). Observed eradication rate varied greatly across different regimens: 57.1% (2nd line levofloxacin), 59.6% (unconventional), 70.7% (7-day triple), 73.2% (7-day undefined), 89% (10-day sequential) and 96.9% (ITT, 10 day Pylera®, 1st to 5th line regimens given to 227 patients).Conclusions. A heterogeneous “real life” scenario in Southern Europe shows that H. pylori+ve patients are put at risk of poor outcomes and points to the need of a susceptibility-based therapy according to guidelines and local microbial resistance. In the present setting (i.e. high clarithromycin resistance), despite the high observed eradication rate, sequential therapy should not be recommended (absent in guidelines, unneeded antibiotic). Bismuth-based quadruple treatment (1st, 2nd or subsequent lines) yields the highest eradication rates.Abbreviations: ALT: Altamura; BA: Bari; EGDS: esophagogastroduodenoscopy; GERD: gastro-esophageal reflux disease; H. pylori: Helicobacter pylori; ITT: intention-to-treat; PP: per-protocol; PPI: proton pump inhibitor; UBT: urea breath test.

scholarly journals Helicobacter pyloriInfection: Is Sequential Therapy Superior to Standard Triple Therapy? A Single-Centre Italian Study in Treatment-Naive and Non-Treatment-Naive Patients

2011 ◽  
Vol 25 (6) ◽  
pp. 315-318 ◽  
Author(s):  
R Urgesi ◽  
G Pelecca ◽  
R Cianci ◽  
A Masini ◽  
C Zampaletta ◽  
...  
Keyword(s):  
Triple Therapy ◽  
Breath Test ◽  
Sequential Therapy ◽  
Urea Breath Test ◽  
First Line ◽  
Randomized Controlled ◽  
Standard Triple Therapy ◽  
End Of Treatment ◽  
Treatment Naïve ◽  
H Pylori

BACKGROUND: Clarithromycin resistance has decreased the eradication rates ofHelicobacter pylori.AIMS: To determine whether a 10-day course of sequential therapy (ST) is more effective at eradicatingH pyloriinfection than triple therapy (TT) in the first or second line, and to assess side effects and compliance with therapy.METHODS: One hundred sixty treatment-naive and 40 non-treatment-naive patients who were positive forH pyloriinfection by13C-urea breath test or endoscopy were enrolled. Eighty of 160 patients underwent TT, while 80 of 160 underwent ST with omeprazole (20 mg) plus amoxicillin (1 g) twice/day for five days, followed by omeprazole (20 mg) with tinidazole (500 mg) twice/day and clarithromycin (500 mg) twice/day for five consecutive days.H pylorieradication was evaluated by13C-urea breath test no sooner than four weeks after the end of treatment.RESULTS: Eradication was achieved in 59 of 80 treatment-naive patients treated with TT (74%), in 74 of 80 patients treated with ST (93%), and in 38 of 40 non-treatment-naive patients (95%). Eradication rates in treatment-naive patients with ST were statistically significantly higher than TT (92.5% versus 73.7%; P=0.0015; OR 4.39 [95% CI 1.66 to 11.58]). Mild adverse effects were reported for both regimens.CONCLUSIONS: ST appears to be a well-tolerated, promising therapy; however, randomized controlled trials with larger and more diverse sample populations are needed before it can be recommended as a first-line treatment.

scholarly journals Risk Factors and Prevalence ofHelicobacter pyloriInfection in Persistent High Incidence Area of Gastric Carcinoma in Yangzhong City

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Yangchun Zhu ◽  
Xiaoying Zhou ◽  
Junbei Wu ◽  
Jing Su ◽  
Guoxin Zhang
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Breath Test ◽  
Multivariate Logistic Regression Analysis ◽  
Urea Breath Test ◽  
Epidemiologic Survey ◽  
Significant Difference ◽  
High Prevalence ◽  
13C Urea Breath Test ◽  
H Pylori

Aim. The aim of this study was to investigate the prevalence and risk factors ofH. pyloriinfection in areas with high prevalence of gastric cancer in Jiangsu Province, China.Methods. A prospective epidemiologic survey ofH. pyloriinfection was accomplished in a natural population of 5417 individuals in Yangzhong city. Questionnaires and 13C-urea breath test forH. pyloriinfection were performed.Results. Among 5417 subjects who completed questionnaires and 13C-urea breath test, 3435 (63.41%) wereH. pyloripositive. The prevalence reached a peak at the age of 30–39 years (90.82%). There was significant difference between sexes and women had a higher infection rate than men. The prevalence ofH. pyloriinfection was also associated with eating kipper food and fried food. No association betweenH. pyloriprevalence and smoking or drinking was found. Compared to healthy individuals, people with dyspeptic diseases (peptic ulcer, gastroenteritis) presented a high prevalence ofH. pyloriinfection. Using multivariate logistic regression analysis, age and history of peptic ulcer and gastroenteritis were the independent predictors forH. pyloriinfection.Conclusions. Yangzhong city had a high prevalence ofH. pyloriinfection and was related to several risk factors. The underlying mechanisms are needed to be further investigated.

scholarly journals Two-week Triple Therapy with either Standard or High-dose Esomeprazole for First-line H. pylori Eradication

2016 ◽  
Vol 25 (2) ◽  
pp. 147-150 ◽  
Author(s):  
Vincenzo De Francesco ◽  
Lorenzo Ridola ◽  
Cesare Hassan ◽  
Annamaria Bellesia ◽  
Domenico Alvaro ◽  
...  
Keyword(s):  
Triple Therapy ◽  
Proton Pump ◽  
High Dose ◽  
Double Dose ◽  
First Line ◽  
Therapy Regimen ◽  
Dose Therapy ◽  
Intention To Treat ◽  
Significant Difference ◽  
H Pylori

Background & Aims: The updated Italian guidelines advise a standard 14-day triple therapy for first-line H. pylori eradication. This prospective study evaluated the cure rate following a 14-day triple therapy with either a standard or double-dose proton pump inhibitor (PPI). Methods. A total of 145 consecutive patients with H. pylori infection were randomized to receive a 14-day, first-line triple therapy with clarithromycin 500 mg, amoxicillin 1 g and esomeprazole at either 20 mg (standard therapy) or 40 mg (double-dose therapy), each given twice daily. Results. At intention-to-treat analysis, H. pylori infection was cured in 73.9% (95% CI: 63.9−84) and 81.9% (95% CI: 73−90.8) following standard and double-dose therapy, respectively, and in 78.2% (95% CI: 68.5−87.9) and 85.5% (95% CI: 77.2−93.8) at per-protocol analysis. No statistically significant difference occurred. Overall, 16.4% and 19.4% patients in the standard and double-dose therapy regimen complained of side effects. Conclusion. The success rate of both standard and double-dose 14-day triple therapies for first-line H. pylori treatment was unsatisfactory. A prolonged 14-day levofloxacin-based triple therapy for second-line H. pylori eradication seems to be promising. Abbrevations: ITT: Intention To Treat; NUD: non ulcer dyspepsia; PP: PerAdd Contributor Protocol; PPI: proton pump inhibitors; PUD: peptic ulcer disease; UBT: urea breath test.

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