Efficacy of a triple therapy for Helicobacter pylori eradication in a well-developed urban area in Brazil

Bellelis, Patrick; Samano, Eliana Sueco Tibana; Nunes, Ricardo Cruz; Ribeiro, Lia de Melo; Chehter, Ethel Zimberg; Catapani, Wilson Roberto

doi:10.1590/s1516-31802004000200009

Cited by 5 publications

(4 citation statements)

References 3 publications

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“…In our study, the eradication rates were 88.8% (95% CI 86%-92%) per protocol and 82.7% (95% CI 79%-86%) according to the intention to treat. These results are similar to those observed in the works of Bellelis [20], and Coelho [22] in research studies also conducted in Brazil. Results in works from Taiwan [23], Kuwait [24], Hong Kong [25], Iran [26], and Chile [27] have presented similar results regarding the efficacy of triple therapy.…”

Section: Discussionsupporting

confidence: 92%

“…Triple therapy with PPI, amoxicillin, and clarithromycin has been evaluated in several clinical trials [15][16][17][18][19][20], but data regarding its efficiency and tolerability in Brazil are scarce [21,22,[28][29][30]. This study was designed to evaluate the rate of success and the safety profile of standard therapy in a large cohort of Brazilian patients with PUD and welldocumented H. pylori infection.…”

Section: Introductionmentioning

confidence: 99%

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Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients

Felga

Silva

Navarro–Rodriguez

et al. 2010

J Infect Dev Ctries

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Introduction: The scheme proton pump inhibitor/amoxicillin/clarithromycin (PPI/AC) is still the first-line treatment for Helicobacter pylori (H. pylori) infections despite evidence suggesting its failure in up to 20% to 30% of patients. Methodology: This study involved 493 patients who were prescribed omeprazole (20 mg twice a day) or another proton pump inhibitor in equivalent dosage, amoxicillin (1 g twice a day), and clarithromycin (500 mg twice a day) for seven days. Efficacy was determined by negative urease test and absence of H. pylori on gastric biopsy samples twelve weeks after the end of treatment. Safety was defined according to the adverse effects reported. Mean age of the patients was (± SD) 48.96 ± 13, and demographic and clinical data were recorded for correlation with treatment outcomes. Results: Out of 493 patients, 316 (64.1%) presented duodenal ulcer, 111 (22.5%) gastric ulcer, and 66 (14.4%) simultaneous gastric and duodenal ulcers. Additionally, 267 (54.2%) patients had at least one risk factor for peptic ulcer disease, smoking being the most common (99 [36.5%]). Successful eradication was achieved in 408 patients. The eradication rates per protocol, and according to the intention to treat, were 88.8% and 82.7%, respectively. Of 164 (35.5%) patients who presented adverse effects, 100 (61%) reported them as mild and only six (3.7%) patients had to discontinue treatment. Previous use of tobacco and non-steroid anti-inflammatory drugs was the only risk factor for treatment failure (P 0.00). Conclusion: PPI/AC is still a valuable and remarkably tolerable option for first-line H. pylori eradication in Brazil.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients

Felga

Silva

Navarro–Rodriguez

et al. 2010

J Infect Dev Ctries

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“…Guidelines for the eradication of H. pylori have been recommended in Brazil [24]; however, it was not the purpose of this study to determine the efficacy of a treatment, but to compare two patient groups. In Brazil, it has been shown that therapeutic efficacies vary from 85.1% to 89% in different regions depending on socioeconomic levels [25]. In the present study, the eradication rate in the control group was 85%, coinciding with previous values.…”

Section: Discussionsupporting

confidence: 86%

Evaluation of the efficacy of triple therapy regimen for Helicobacter pylori eradication in gastrectomized patients with gastric adenocarcinoma

et al. 2006

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the Helicobacter pylori in this association being discovered at the end of the last century by Marshall and Warren. Since then, studies have related H. pylori to several gastric illnesses, including gastric cancer [1,2]. The eradication of this bacteria is one of the subjects most studied in this regard [3,4]. Most of the published studies are about the eradication of H. pylori in nonoperated stomachs; however, there are few references to this eradication in gastrectomized patients; in particular, in those with a Roux-en-Y diversion [5]. As far as we know the efficacy of antibiotics for the eradication of H. pylori depends on several factors: the gastric pH, the level of drug in the gastric mucosa, and acquired resistance [6]. These factors could explain some of the alterations that occur in the efficacy of H. pylori eradication when medications are used in patients with a partially removed stomach.The cause of gastric stump cancer is multifactorial, and H. pylori seems to be one of these factors [7]. The eradication of H. pylori decreases the risk of the development of gastric stump cancer [8]. Therefore, it is considered of fundamental importance to carry out a clinical study that could verify the efficacy of a triple therapy regimen in gastrectomized patients. This study was carried out to compare the efficacy of H. pylori eradication with a triple therapy regimen (clarithromycin, amoxicillin, and lansoprazole) in gastrectomized and nongastrectomized patients, having as an hypothesis that there could be alterations in the efficacy of the treatment (due to the physiological and anatomical differences of the gastrectomized stomach), which could mean that a new therapeutic regimen would be needed. AbstractBackground. The cause of cancer in the gastric stump is multifactorial, and Helicobacter pylori is one of these factors. Its eradication has been recommended; however, there are few studies about of H. pylori eradication in gastrectomized patients. Methods. Twenty gastrectomized patients with gastric adenocarcinoma and Roux-en-Y reconstruction (study group) infected by H. pylori were compared with nongastrectomized patients (control group) also infected by H. pylori. The presence of H. pylori was determined by the ultra-quick urease test and from a histological sample obtained by endoscopy. Both groups received the same triple therapy regimen. Results. The rate of eradication of H. pylori in the study group was 90% and in the control group, it was 85%. Sex, age, and postoperative time did not influence the rate of eradication. Conclusion. There were no differences in the efficacy of H. pylori eradication between the two groups; therefore, the triple therapy regimen is effective for the eradication of H. pylori in gastrectomized patients with a Roux-en-Y reconstruction.

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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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Efficacy of a triple therapy for Helicobacter pylori eradication in a well-developed urban area in Brazil

Cited by 5 publications

References 3 publications

Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients

Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients

Evaluation of the efficacy of triple therapy regimen for Helicobacter pylori eradication in gastrectomized patients with gastric adenocarcinoma

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

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