Azithromycin based triple therapy versus standard clarithromycin based triple therapy in eradication of Helicobacter pylori infection in Iran: a randomized controlled clinical trial

Sarkeshikian, Seyed Saeid; Iranikhah, Abolfazl; Ghadir, Mohammad Reza

doi:10.4318/tjg.2013.0540

Cited by 10 publications

(14 citation statements)

References 38 publications

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“…During the previous years, four studies have evaluated the efficacy of azithromycin-containing regimens for H. pylori eradication, but none of these regimens could achieve acceptable eradication rates. 29 , 35 , 44 , 47 In 2006, Mousavi and colleagues assessed the efficacy of bismuth-based azithromycin-containing regimen in Semnan. 47 Also, in 2009, a subsequent study evaluated the efficacy of the same regimen in Tehran.…”

Section: Introductionmentioning

confidence: 99%

Eradication of Helicobacter Pylori in Iran: A Review

Fakheri

Firoozi²,

Bari

2017

Middle East J Dig Dis

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Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections, affecting almost half of the world’s population. It is associated with peptic ulcer disease, gastric adenocarcinoma, and lymphoma. In Iran, the prevalence of H. pylori infection has been reported to be between 36% and 90% in different geographic regions. Several studies have assessed the efficacy of different therapeutic options for firstline and second-line H. pylori eradication in Iran; however, the results are conflicting. Therefore, we conducted a review to evaluate different studies in order to select the best options and to provide recommendations for H. pylori eradication in Iran. Accordingly, we searched through PubMed to obtain relevant randomized clinical trials published in English language up to June 2017. According to our study, among first-line eradication regimens, bismuth-based furazolidone- or clarithromycin-containing quadruple therapies, hybrid regimen, and concomitant therapy seem to be appropriate options. Also, 10- or 14-day clarithromycin-containing triple therapy can be used if local H. pylori resistance to clarithromycin is known to be less than 15%. For second-line H. pylori eradication, bismuth-based quadruple therapies and 14-day levofloxacin-based triple therapy can be used, provided that antibiotics other than those used in the first-line regimen are used. Third-line H. pylori eradication regimens have not been addressed in Iranian studies. However, most guidelines recommend treatment according to the results of culture and susceptibility testing. Although we limited our investigation to H. pylori eradication regimens in Iran, the results are transferrable to any region as long as the patterns of antibiotic resistance are the same.

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Section: Introductionmentioning

confidence: 99%

Eradication of Helicobacter Pylori in Iran: A Review

Fakheri

Firoozi²,

Bari

2017

Middle East J Dig Dis

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“…In a study conducted by Sarkeshikian et al ( 25 ), 165 adult patients with symptoms of dyspepsia were divided into two groups; the first group (89 patients) was treated with omeprazole, amoxicillin, and azithromycin and the second group (76 patients) with amoxicillin, omeprazole, and clarithromycin. According to the breath test performed 6 weeks later; the eradication rate was 75% in the first group and 82% in the second group, and there was no statistically significant difference between the two groups ( 25 ). This study was consistent with our study regarding the lack of significant difference in the therapeutic response between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Eradication of Helicobacter pylori in Children by Triple Therapy Regimens of Amoxicillin, Omeprazole, and Clarithromycin or Azithromycin

2015

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Background and Objectives:The present study aimed to evaluate the effect of classical and azithromycin-containing triple therapy eradication regimen against H. Pylori in children, and to determine the level of patients’ tolerance.Patients and Methods:This single clinical trial was performed in 2014 on 2 to 15 years old children. All children, in whom H. Pylori infection was confirmed through multiple biopsies of the stomach and required treatment, were enrolled in the study. H. Pylori-positive patients were treated alternately with two different drug regimens; Group OCA received clarithromycin 7.5 mg/kg/day every 12 hours for 10 days, amoxicillin 50 mg/kg/day every 12 hours for 10 days, and omeprazole 1 mg/kg/day every 12 hours for two weeks, and Group OAA received azithromycin 10 mg/kg/day once a day (before meal) for 6 days along with amoxicillin and omeprazole. Four to six weeks after completion of treatment, patients’ stool was tested for H. Pylori through the monoclonal method using the Helicobacter antigen quick kit.Results:There were no significant differences between the two groups regarding gender and age of patients. Based on ITT analysis, the therapeutic response in the OAA and OCA groups were 56.2% and 62.5%, respectively (P = 0.40). Drug adverse effects were 15.6% in the OCA and 3.1% in the OAA group (P = 0.19).Conclusions:The therapeutic response was seen in more than half of the patients treated with triple therapy of H. Pylori eradication regimen including azithromycin or clarithromycin, and there was no significant difference between the two treatment groups.

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“…Out of three 7-d regimens, 1 study showed acceptable eradication rates [19][20][21] . Also, out of three 10-d regimens, 2 were successful in achieving > 90% PP eradication rate [22][23][24] and out of three 14-d regimens, 1 yielded optimal results [25][26][27] .…”

Section: Standard Triple Therapymentioning

confidence: 99%

Helicobacter pylorieradication in West Asia: A review

Fakheri

Bari

Aarabi

et al. 2014

WJG

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The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. However, no review article has yet evaluated and compared the efficacy of different regimens among different countries of this region. Therefore, we conducted a review to select the best options and provide recommendations for H. pylori treatment in this geographic region. A search through PubMed was carried out to obtain relevant randomized clinical trials published in English language up to June 2013. According to the results, among different therapeutic regimens used as the first-line protocols, 10-d Bismuth-Furazolidone/Metronidazole quadruple therapy, 14-d Clarithromycin-containing hybrid therapy and 14-d quadruple therapy including a proton pump inhibitor + Bismuth + Tetracycline (500 mg QID) + Metronidazole (500 mg TDS) seemed to be appropriate options. Among second-line therapeutic regimens, Bismuthbased quadruple therapies containing Tetracycline and Furazolidone/Metronidazole, triple therapy containing Amoxicillin and Gatifloxacin and Quadruple therapy including Bismuth + Azithromycin and Ofloxacin seemed to be effective options. Third-line therapies were not evaluated in West Asia; most guidelines, however, recommend choosing optimal eradication regimen according to the pattern of antibiotic susceptibility of H. pylori . Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same. Core tip: The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. The present study evaluates and compares the efficacy of different regimens among different countries of this region. Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same.

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Azithromycin based triple therapy versus standard clarithromycin based triple therapy in eradication of Helicobacter pylori infection in Iran: a randomized controlled clinical trial

Cited by 10 publications

References 38 publications

Eradication of Helicobacter Pylori in Iran: A Review

Eradication of Helicobacter Pylori in Iran: A Review

Eradication of Helicobacter pylori in Children by Triple Therapy Regimens of Amoxicillin, Omeprazole, and Clarithromycin or Azithromycin

Helicobacter pylorieradication in West Asia: A review

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