Metronidazole-based quadruple versus standard triple therapy: which is better as first-line therapy forHelicobacter pylorieradication?

2011 ◽  
Vol 4 (5) ◽  
pp. 579-582 ◽  
Author(s):  
Hidekazu Suzuki ◽  
Juntaro Matsuzaki ◽  
Toshifumi Hibi
Keyword(s):  
Triple Therapy ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Standard Triple Therapy

scholarly journals Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis

2021 ◽  
Vol 21 (1) ◽  
pp. 35-47
Author(s):  
Seung Joo Kang ◽  
Hye-Kyung Jung ◽  
Yong Chan Lee ◽  
Hyo-Joon Yang ◽  
Seon-Young Park ◽  
...  
Keyword(s):  
Triple Therapy ◽  
Eradication Rate ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Library ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Randomized Controlled Studies ◽  
Standard Triple Therapy

Background/Aims: Standard triple therapy, including a proton pump inhibitor, clarithromycin, and amoxicillin, has been recommended as the first-line for <i>Helicobacter pylori</i> infection. However, the eradication rate of standard triple therapy has declined over the past years because of the increasing resistance to clarithromycin in Korea. We analyzed the eradication rates and the 10-year change in the eradication rates in Korea.Methods: PubMed, EMBASE, the Cochrane Library, and KoreaMed were searched for studies published between January 2007 and June 2018. The pooled eradication rates and their 95% CIs were estimated using a random-effect logistic regression model.Results: Twenty-six randomized controlled studies on standard triple therapy conducted in Korea were selected. The intention-to-treat (ITT) and per protocol analyses showed pooled eradication rates of standard triple therapy of 71.6% (95% CI, 69.9~73.3%) and 79.6% (95% CI, 76.6~82.2%), respectively. The eradication rate decreased with time. The ITT analysis showed that the 14-day therapy (78.1% [95% CI, 75.2~80.7%]) had significantly higher eradication rates than the 7-day therapy (70.0% [95% CI, 68.5~71.4%]) (<i>P</i><0.01).Conclusions: These results suggest that the eradication rate of standard triple therapy, as the first-line therapy, has shown an unacceptable decrease. The eradication rate increased when the duration of therapy was increased to 14 days, but it was not satisfactory. Therefore, other treatment regimens or therapies based on susceptibility tests should be considered for the first-line therapy.

scholarly journals Is It Time for Quadruple Therapy to be First Line?

2003 ◽  
Vol 17 (suppl b) ◽  
pp. 33B-35B ◽  
Author(s):  
Loren Laine
Keyword(s):  
Triple Therapy ◽  
Randomized Trials ◽  
Eradication Rate ◽  
First Line ◽  
Quadruple Therapy ◽  
First Line Therapy ◽  
Clarithromycin Resistance ◽  
Line Therapy ◽  
Metronidazole Resistance ◽  
H Pylori

The most commonly used regimen forHelicobacter pyloritherapy at present is twice-daily proton pump inhibitor (PPI)-based triple therapy. Bismuth-based therapy is the next most common treatment used by gastroenterologists. When a PPI is combined with bismuth-based triple therapy (quadruple therapy), eradication rates are increased as compared with the triple therapy alone. Three separate randomized trials from three continents that compare quadruple therapy and PPIbased triple therapy revealed remarkably similar results. Eradication rates with PPI-based triple therapy and quadruple therapy were not significantly different. The eradication rates with quadruple therapy were 3% to 6% higher than PPI triple therapy, indicating that quadruple therapy should be no less effective than PPI triple therapy. Furthermore, these two therapies had similar rates of compliance and adverse events.The major potential benefit of the quadruple therapy relates to antibiotic resistance. In patients with clarithromycin resistance, PPIbased triple therapy, but not quadruple therapy, had a significantly lower eradication rate. However, due to its ability to largely overcome metronidazole resistance, quadruple therapy had little if any decrement in eradication rates compared with PPI triple therapy in patients with metronidazole-resistantH pylori. Therefore, quadruple therapy can be considered a first line therapy forH pylori.

Levofloxacin and proton pump inhibitor-based triple therapy versus standard triple first-line therapy forHelicobacter pylorieradication

2014 ◽  
Vol 23 (5) ◽  
pp. 443-455 ◽  
Author(s):  
Chen-Li Ye ◽  
Guo-Ping Liao ◽  
Shuai He ◽  
Yan-Na Pan ◽  
Ying-Bo Kang ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Triple Therapy ◽  
Proton Pump ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

EFFICACY OF H.PYLORI ERADICATION TREATMENT WITH LEVOFLOXACIN – BASED TRIPLE THERAPY IN GASTRODUODENITISS PATIENTS

2011 ◽  
pp. 35-41
Author(s):  
Quang Di Bui ◽  
Trong Thang Hoang
Keyword(s):  
Adverse Effects ◽  
Triple Therapy ◽  
Cross Sectional Study ◽  
First Line ◽  
Second Line Therapy ◽  
Cross Sectional ◽  
Intention To Treat ◽  
Line Therapy ◽  
Standard Triple Therapy

Objective: This study is to evaluate the efficacy, tolerability and adverse effects of a triple second line therapy including of Rabeprazole, Amoxicilin và Levofloxacin in patients who have failed first-line Helicobacter pylory (H.Pylori) therapy. Methods: By descriptive cross-sectional study, the authors have examined 101 gastro-duodenitis patients, who had failed first treatment with standard triple therapy, received 10-days therapy including Rabeprazole (20mg b.d), Levofloxacin (500mg b.d) and Amoxycillin (1g b.d). Eradication is confirmed with by the C13-urea breat h test after 4 weeks from completing of treatment. Results: 100% of patients are initially included and noboby is lost for follow-up. Mean age was 44 yr, 38% were male, 68,3% had duodenitis, 20,7% gastritis, 11% gastro-duodenitis. All patients took medications correctly. Per-protocol and intention to treat eradication rates were both 83,3% (95% CI=75,4-91,3). Mild adverse effects were reported overall in 8% of the patients, mainly including rash 2%, myalgias 2% and diarrhea 5%, none of them were severe. Conclusion: This ten-days levofloxacin-base therapy represents an alternative to standard quadruple therapy in patents with previous PPI-Clarithromycin-Amoxicillin failure, being effective, safe and simple.

scholarly journals Comparing the Efficacy of Concomitant Therapy with Sequential Therapy as the First-Line Therapy ofHelicobacter pyloriEradication

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Sung Min Jung ◽  
Dae Young Cheung ◽  
Jin Il Kim ◽  
Il Kim ◽  
Hyeonjin Seong
Keyword(s):  
Statistical Difference ◽  
Sequential Therapy ◽  
Concomitant Therapy ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Standard Triple Therapy ◽  
Sequential Group ◽  
13C Urea Breath Test ◽  
H Pylori

Background. The decline ofHelicobacter pylori(H. pylori) eradication rates with standard triple therapy resulted in a search for novel therapies for first-line therapy ofH. pyloriinfection.Aim. The aim of the study is to compare the efficacy of concomitant therapy with sequential therapy as the first-line therapy ofH. pylorieradication.Methods. We reviewed medical records of patients who were confirmed to haveH. pyloriinfection and received eradication treatment from September 2012 to March 2015. The concomitant group was treated with rabeprazole, amoxicillin, clarithromycin, and metronidazole for 7 days. The sequential group was treated with rabeprazole and amoxicillin for 5 days and then rabeprazole, clarithromycin, and metronidazole for an additional 5 days. Six weeks after the treatment period, patients in both groups underwent 13C-Urea breath test (UBT) to confirmH. pylorieradication.Results. The eradication rate was 90.3% in the concomitant group and 85.5% in the sequential group. However, the eradication rates between the two groups showed no statistical difference (P=0.343).Conclusion. No statistical difference was found in eradication rates between the two groups. However, in areas where antibiotic resistance is high, concomitant therapy may be more effective than sequential therapy forH. pylorieradication.

Sign in / Sign up

Export Citation Format

Share Document