One‐day intensified lansoprazole‐quadruple therapy for cure of <i>Helicobacter pylori</i> infection

Boer, W. A. De; Etten, R. J. X. M. Van; Rr, Schade; Ouwehand, Mariët; Schneeberger, Peter M.; Unnik, A. J. M. Van; Tytgat, G. N. J.

doi:10.1046/j.1365-2036.1997.121292000.x

Cited by 54 publications

(62 citation statements)

References 25 publications

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“…4, 6±8, 22 It has been suggested that metronidazole resistance may be overcome by the addition of a proton pump inhibitor (quadruple therapy) with only 1 week of therapy. 21,23,24 We asked whether a twice a day combination of BMT plus the proton pump inhibitor, lansoprazole (b.d. quadruple therapy) would have promise for the treatment of H. pylori infection.…”

Section: Introductionmentioning

confidence: 99%

Twice a day quadruple therapy (bismuth subsalicylate, tetracycline, metronidazole plus lansoprazole) for treatment of Helicobacter pylori infection

Graham

Hoffman

El‐Zimaity

et al. 1997

Aliment Pharmacol Ther

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Background: Quadruple therapy (bismuth, metronidazole and tetracycline (BMT) + proton pump inhibitor) is touted as being >95% effective, regardless of metronidazole resistance. We tested a 10‐day b.d. quadruple therapy for treatment of H. pylori infection. Methods: Anti‐H. pylori therapy consisted of lansoprazole 15 mg b.d. plus tetracycline 500 mg b.d., metronidazole 500 mg b.d., and swallowable Pepto‐Bismol caplets (2 b.d.) for 10 days. H. pylori status was evaluated by culture and histology before and 4 or more weeks after therapy. Results: The cure rate for intention‐to‐treat was 70%. Treatment success was calculated overall and separately in relation to antimicrobial resistance patterns. The cure rate among the metronidazole‐sensitive isolates was 89.7% (26 of 29) vs. 41.2% (7 of 17) of the metronidazole‐resistant isolates (P < 0.005). Moderate (n = 1) or severe (n = 3) side‐effects were experienced in four patients with only one withdrawing because of side‐effects. Conclusion: Twice a day quadruple therapy is effective for metronidazole‐sensitive strains but its usefulness is markedly reduced by the presence of pre‐treatment metronidazole resistance. Twice a day quadruple therapy can be recommended in locations where background metronidazole resistance is uncommon. Possibly, 14‐day therapy or a higher dosage of metronidazole provide better results with metronidazole‐resistant H. pylori.

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Section: Introductionmentioning

confidence: 99%

Twice a day quadruple therapy (bismuth subsalicylate, tetracycline, metronidazole plus lansoprazole) for treatment of Helicobacter pylori infection

Graham

Hoffman

El‐Zimaity

et al. 1997

Aliment Pharmacol Ther

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“…In addition, several studies have found an eradication rate lower than 75% (6,11,59), and values as low as 25 to 45% have also been recently reported (22,24). Thus, prolonged standard triple therapy for up to 2 weeks has been recommended (9,23,34), and in cases of eradication failure, a quadruple therapy with a proton pump inhibitor, bismuth salt, tetracycline, and metronidazole has been advised as a second-line therapy (8,13,44). More recently, sequential therapy (PPI and amoxicillin for 5 days, followed by PPI, clarithromycin, and tinidazole for 5 days) has become very attractive for clinical practice since impressive efficacy was seen (36,73).…”

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confidence: 99%

In Vitro Antibacterial Activity of Acyl-Lysyl Oligomers againstHelicobacter pylori

Makobongo

Kovachi

Gancz

et al. 2009

Antimicrob Agents Chemother

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The gastric pathogen Helicobacter pylori has developed resistance to virtually all current antibiotics; thus, there is a pressing need to develop new anti-H. pylori therapies. The goal of this work was to evaluate the antibacterial effect of oligo-acyl-lysyl (OAK) antimicrobial peptidomimetics to determine if they might represent alternatives to conventional antibiotic treatment of H. pylori infection. A total of five OAK sequences were screened for growthinhibitory and/or bactericidal effects against H. pylori strain G27; four of these sequences had growth-inhibitory and bactericidal effects. The peptide with the highest efficacy against strain G27, C 12 K-2␤ 12 , was selected for further characterization against five additional H. pylori strains (26695, J99, 7.13, SS1, and HPAG1). C 12 K-2␤ 12 displayed MIC and minimum bactericidal concentration (MBC) ranges of 6.5 to 26 M and 14.5 to 90 M, respectively, across the six strains after 24 h of exposure. G27 was the most sensitive H. pylori strain (MIC ‫؍‬ 6.5 to 7 M; MBC ‫؍‬ 15 to 20 M), whereas 26695 was the least susceptible strain (MIC ‫؍‬ 25 to 26 M; MBC ‫؍‬ 70 to 90 M). H. pylori was completely killed after 6 to 8 h of incubation in liquid cultures containing two times the MBC of C 12 K-2␤ 12 . The OAK demonstrated strong in vitro stability, since efficacy was maintained after incubation at extreme temperatures (4°C, 37°C, 42°C, 50°C, 55°C, 60°C, and 95°C) and at low pH, although reduced killing kinetics were observed at pH 4.5. Additionally, upon transient exposure to the bacteria, C 12 K-2␤ 12 showed irreversible and significant antibacterial effects and was also nonhemolytic. Our results show a significant in vitro effect of C 12 K-2␤ 12 against H. pylori and suggest that OAKs may be a valuable resource for the treatment of H. pylori infection.Helicobacter pylori is a microaerophilic gram-negative bacterium that colonizes the gastric mucosa. It is known to be a principal gastric pathogen of humans and is associated with the development of gastritis, gastric ulcers, duodenal ulcers, and gastric cancer (46,55,56,60). Approximately half of the world's population is infected with H. pylori (79). Thus, the bacterium poses a significant public health problem, which is further compounded by the fact that H. pylori has developed antimicrobial resistance to virtually all current antibiotics, a phenomenon that is hampering efforts to treat the infection (40, 51).Since the original isolation of H. pylori in the early 1980s, treatment of the bacterial infection has undergone a significant evolutionary development from initial monotherapy to dual, triple, and in more recent trials quadruple therapy (8, 18). Current treatment strategies employ combination therapy, since single-antibiotic therapy often results in failure to eradicate the infection (21). The highest H. pylori eradication rates have been reported with triple therapy, which involves the utilization of two antibiotics in combination with bismuth or a proton pump inhibitor, PPI (34,44). Amoxicillin (amoxicil...

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“…This provoked studies exploring shorter treatment durations. In the Netherlands, four-day quadruple therapy was found to perform well (rate of cure greater than 90%) in metronidazole-sensitive strains, but less so in metronidazole-resistant strains (10)(11)(12)(13)(14). Studies showed that with quadruple therapy, most cures occur in one to four days.…”

Section: Uringmentioning

confidence: 99%

“…One-day and two-day quadruple therapies have been explored (15)(16)(17)(18), but these extremely short regimens proved to be ineffective, with a cure rate of only 60% to 76%. Metronidazole resistance was an important determinant for failure.…”

Section: Uringmentioning

confidence: 99%

Eradication Therapy Should Be Different for Dyspeptic Patients than for Ulcer Patients

Boer

2003

Canadian Journal of Gastroenterology and Hepatology

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One‐day intensified lansoprazole‐quadruple therapy for cure of Helicobacter pylori infection

Cited by 54 publications

References 25 publications

Twice a day quadruple therapy (bismuth subsalicylate, tetracycline, metronidazole plus lansoprazole) for treatment of Helicobacter pylori infection

Twice a day quadruple therapy (bismuth subsalicylate, tetracycline, metronidazole plus lansoprazole) for treatment of Helicobacter pylori infection

In Vitro Antibacterial Activity of Acyl-Lysyl Oligomers againstHelicobacter pylori

Eradication Therapy Should Be Different for Dyspeptic Patients than for Ulcer Patients

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