Factors affecting Helicobacter pylori eradication using a seven-day triple therapy with a proton pump inhibitor, tinidazole and clarithromycin, in brazilian patients with peptic ulcer

Silva, Fernando Marcuz; Zaterka, Schlioma; Eisig, Jaime Natan; Chehter, Ethel Zimberg; Chinzon, Décio; Laudanna, Antônio Atílio

doi:10.1590/s0041-87812001000100003

Cited by 22 publications

(21 citation statements)

References 23 publications

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“…In our country, H pylori strains show an intrinsic resistance to metronidazole that reaches 50%, which decreases the efficacy of schemes containing this drug or other nitroimidazolics [16][17][18][19] . Furazolidone is widely available in public health care facilities in Brazil.…”

Section: Discussionmentioning

confidence: 99%

Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

Felga¹,

Silva²,

Barbuti³

et al. 2008

WJG

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AIM:To establish the efficacy and safety of a 7-d therapeutic regimen using omeprazole, bismuth subcitrate, furazolidone and amoxicillin in patients with peptic ulcer disease who had been previously treated with other therapeutic regimens without success. METHODS: Open cohort study which included patients with peptic ulcer who had previously been treated unsuccessfully with one or more eradication regimens. The therapeutic regimen consisted of 20 mg omeprazole, 240 mg colloidal bismuth subcitrate, 1000 mg amoxicillin, and 200 mg furazolidone, taken twice a day for 7 d. Patients were considered as eradicated when samples taken from the gastric antrum and corpus 12 wk after the end of treatment were negative for Helicobacter pylori (H pylori ) (rapid urease test and histology). Safety was determined by the presence of adverse effects. RESULTS: Fifty-one patients were enrolled. The eradication rate was 68.8% (31/45). Adverse effects were reported by 31.4% of the patients, and these were usually considered to be slight or moderate in the majority of the cases. Three patients had to withdraw from the treatment due to the presence of severe adverse effects. C O N C L U S I O N :T h e a s s o c i a t i o n o f b i s m u t h , furazolidone, amoxicillin and a proton-pump inhibitor is a valuable alternative for patients who failed to respond to other eradication regimens. It is an effective, cheap and safe option for salvage therapy of positive patients.

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Section: Discussionmentioning

confidence: 99%

Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

Felga¹,

Silva²,

Barbuti³

et al. 2008

WJG

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“…In spite of the different designs, most studies have reported eradication rates around 90%, 23,24 with the exception of an open, non- controlled study from Brazil, which used the same regimen as ours and reported an eradication rate of only 65%. 25 A recent, non-blind trial from Vietnam found an eradication rate of 91% with a regimen of amoxicillin, clarithromycin and omeprazole for 10 days. 26 This study used 500 mg of clarithromycin and a high dose of amoxicillin.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori eradication and peptic ulcer healing: the impact of deleting the proton pump inhibitor and using a once‐daily treatment

Wheeldon

Hoang

Phung

et al. 2003

Aliment Pharmacol Ther

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SUMMARYAim: To compare cheaper and simpler once-daily regimens, with and without a proton pump inhibitor, with standard, twice-daily, triple therapy. Methods: A randomized, placebo-controlled, treatment trial in Vietnam allocated 296 Helicobacter pyloriinfected patients with peptic ulcer of ‡ 5 mm to one of three regimens: (i) twice-daily: lansoprazole 30 mg, clarithromycin 250 mg and tinidazole 500 mg; (ii) once-daily: lansoprazole 60 mg, clarithromycin 500 mg and tinidazole 1000 mg; (iii) once-daily: placebo, clarithromycin 500 mg and tinidazole 1000 mg. H. pylori status was assessed by culture and immunoblot, ulcer healing by endoscopy and side-effects by structured questionnaires.Results: Per protocol eradication (N ¼ 256) was higher with standard therapy (87%) than with once-daily therapy (72%), and both were better than once-daily therapy without proton pump inhibitor (39%). Per protocol ulcer healing after standard therapy (83%) was not significantly better than that after once-daily therapy (73%), but better than that after therapy without proton pump inhibitor (65%). Side-effects were reported at similar rates in all groups. Conclusions: Proton pump inhibitor was needed for optimal eradication and ulcer healing. Twice-daily administration showed improved success rates when compared with once-daily therapies. Peptic ulcer healing was achieved even in patients treated with antibiotics only, confirming the central role of H. pylori in the pathophysiology of peptic ulcer disease.

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“…Whereas the first-line eradication regimens fail to eradicate H. pylori in 5 to 20% of patients in developed countries[6], this percentage tends to be higher in developing countries such as Brazil (15–30%) [7-10]. …”

Section: Introductionmentioning

confidence: 99%

Efficacy of a 7-day course of furazolidone, levofloxacin, and lansoprazole after failed Helicobacter pylorieradication

et al. 2009

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BackgroundIncreasing resistance to clarithromycin and nitroimidazole is the main cause of failure in the Helicobacter pylori eradication. The ideal retreatment regimen remains unclear, especially in developing countries, where the infection presents high prevalence and resistance to antibiotics. The study aimed at determining the efficacy, compliance and adverse effects of a regimen that included furazolidone, levofloxacin and lansoprazole in patients with persistent Helicobacter pylori infection, who had failed to respond to at least one prior eradication treatment regimen.MethodsThis study included 48 patients with peptic ulcer disease. Helicobacter pylori infection was confirmed by a rapid urease test and histological examination of samples obtained from the antrum and corpus during endoscopy. The eradication therapy consisted of a 7-day twice daily oral administration of lansoprazole 30 mg, furazolidone 200 mg and levofloxacin 250 mg. Therapeutic success was confirmed by a negative rapid urease test, histological examination and 14C- urea breath test, performed 12 weeks after treatment completion. The Chi-square method was used for comparisons among eradication rates, previous treatments and previous furazolidone use.ResultsOnly one of the 48 patients failed to take all medications, which was due to adverse effects (vomiting). Per-protocol and intention-to-treat eradication rates were 89% (95% CI- 89%–99%) and 88% (88–92%), respectively. Mild and moderate adverse effects were reported by 41 patients (85%). For patients with one previous treatment failure, the eradication rate was 100%. Compared to furazolidone-naïve patients, eradication rates were lower in those who had failed prior furazolidone-containing regimen(s) (74% vs. 100%, p = 0.002).ConclusionAn empiric salvage-regimen including levofloxacin, furazolidone and lansoprazole is very effective in the eradication of Helicobacter pylori, particularly in patients that have failed one prior eradication therapy.

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Factors affecting Helicobacter pylori eradication using a seven-day triple therapy with a proton pump inhibitor, tinidazole and clarithromycin, in brazilian patients with peptic ulcer

Abstract: A proton pump inhibitor, tinidazole, and clarithromycin bid for seven days resulted in H. pylori eradication in 65% of the patients. Previous treatments were the main cause of treatment failure.

Cited by 22 publications

References 23 publications

Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

Helicobacter pylori eradication and peptic ulcer healing: the impact of deleting the proton pump inhibitor and using a once‐daily treatment

Efficacy of a 7-day course of furazolidone, levofloxacin, and lansoprazole after failed Helicobacter pylorieradication

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