Efficacy of a New Therapeutic Regimen Versus Two Routinely Prescribed Treatments for Eradication of Helicobacter Pylori: A Randomized, Double-Blind Study of Doxycycline, Co-Amoxiclav, and Omeprazole in Iranian Patients

Taghavi, Seyed Alireza; Jafari, Ali Akbar; Eshraghian, Ahad

doi:10.1007/s10620-008-0374-z

Cited by 21 publications

(25 citation statements)

References 27 publications

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“…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. Metaanalysis of published works regarding the differences between the PPI in H. pylori treatment regimens showed eradication rates between 82% and 84% when they were combined with amoxicillin and clarithromycin [15,16].…”

Section: Discussionmentioning

confidence: 67%

“…Upper digestive endoscopy was performed in all patients for peptic ulcer identification and gradation according to the Sakita classification [26], and H. pylori status was determined through rapid urease test and histological examination through a modified Giemsa staining method performed on gastric mucosa samples obtained from the antrum and corpus.…”

Section: Methodsmentioning

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: Discussionmentioning

confidence: 67%

Section: Methodsmentioning

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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“…In the study from Texas [3] , 5 substudies have been performed, comparing the same doxycycline regimen with 5 different regimens without doxycycline. The studies from Italy, Iran and New York [6,8,10] ( table 1 ) [2,3,6,10] . In 5 sub-studies, treatment regimens with doxycycline had significantly higher eradication rate than treatment regimens without doxycycline ( table 1 ) [3,6,10] .…”

Section: Resultsmentioning

confidence: 99%

Doxycycline in Eradication Therapy of <b><i>Helicobacter pylori</i></b> - A Systematic Review and Meta-Analysis

Niv¹

2016

Digestion

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Background: Since resistance of Helicobacter pylori is developing very fast all over the world, new treatment regimens for eradication are urgently needed. Aim: To compare eradication success rate of H. pylori treatment regimens with and without doxycycline. Methods: English medical literature searches were conducted for regimens including doxycycline for eradication of H. pylori. Searches were performed up to August 31, 2015, using MEDLINE, PubMed, EMBASE, Scopus and CENTRAL. Meta-analysis was performed by using comprehensive meta-analysis software. Pooled ORs and 95% CIs were calculated comparing treatment regimens for eradication of H. pylori infection with and without doxycycline. Results: The OR for eradication success rate in a fixed model was in favor for treatment regimens with doxycycline: 1.292, 95% CI 1.048-1.594, p = 0.016. There was no significant heterogeneity in the included studies: Q = 15.130, d.f. (Q) = 8, I² = 47.126, p > 0.10. When treatment regimens with doxycycline were compared only with treatment regimens with tetracycline, no significant difference was found in eradication success rate: OR 0.95, 95% CI 0.68-1.32, p = 0.77. But when treatment regimens with doxycycline were compared with treatment regimens without tetracycline, the OR in favor of doxycycline was even higher: OR 1.59, 95% CI 1.21-2.09, p < 0.001. Conclusion: In this meta-analysis, we confirmed doxycycline efficiency in the eradication of H. pylori. Thus, triple, quadruple or even high dose dual therapy with regimens containing doxycycline should be considered.

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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%

“…Furazolidone has been used in nine quadruple therapies in Iran [23,27,[47][48][49][78][79][80][81] , four of which showed optimal efficacy, although severe side effects were reported in 14-d regimens. Low dose Furazolidone was used in a further study, which led to significant decline in eradication rate [80] .…”

Section: Furazolidonementioning

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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Efficacy of a New Therapeutic Regimen Versus Two Routinely Prescribed Treatments for Eradication of Helicobacter Pylori: A Randomized, Double-Blind Study of Doxycycline, Co-Amoxiclav, and Omeprazole in Iranian Patients

Cited by 21 publications

References 27 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

Doxycycline in Eradication Therapy of <b><i>Helicobacter pylori</i></b> - A Systematic Review and Meta-Analysis

Helicobacter pylorieradication in West Asia: A review

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