One-day therapy for treatment ofHelicobacter pylori infection

Abstract

The present study evaluated the effect of a one-day high-dose combined therapy on Helicobacter pylori infection. Thirty-two consecutive patients (suffering from either peptic ulcer or nonulcer dyspepsia) with Helicobacter pylori infection received omeprazole (40 mg) + bismuth subcitrate (240 mg x 4) + amoxicillin suspension (2000 mg x 4) + metronidazole (500 mg x 4), for only one day. Endoscopy, histology, culture, and susceptibility studies were done at entry and 30 and 90 days after the treatment day. Successful eradication was obtained in 23/32 (72%) patients and gastritis had resolved in 95% of these. Side effects were induced by the treatment in 6/32 (19%) patients, but these were all self-limiting, short-lasting, and did not require any specific treatment. Development of bacterial resistance to metronidazole occurred in 6/9 (67%) non-eradicated patients. These data suggest that one-day treatment with high doses of amoxicillin, metronidazole, bismuth, and omeprazole represents an effective, safe, and inexpensive therapeutic approach for the treatment of H. pylori infection.

Comparison of the efficacy of 1‐day high‐dose quadruple therapy versus 7‐day triple therapy for treatment of Helicobacter pylori infection

“…People are searching for shorter‐term therapy, which might be cheaper, simpler, and with better patient compliance. The ultra‐short quadruple regimen for only 1 day has been reported to be effective by Tucci et al 2 (72%) and Lara et al 6 (95%). They used the same antibiotics (amoxicillin 2 g q.i.d., metronidazole 400 mg or 500 mg q.i.d.)…”

“…In these 1‐day therapeutic studies, most of the medicines given to patients were the same, except the different PPI and one of the antibiotics. Lara et al 6 and de Boer et al 4 used lansoprazole 60 mg per day, while Wermeille et al 5 used lansoprazole 90 mg per day, but the later two studies were much less effective than that of Lara et al Both Tucci et al 2 and Dobrucali et al 3 used omeprazole 40 mg per day. Our patients received esomeprazole 80 mg per day in the 1‐day group; however, the H. pylori eradication seemed not to be influenced by the different PPI chosen in these regimens.…”

“…Several studies have evaluated the efficacies of 1‐day therapy for H. pylori eradication, but they have shown controversial results. Tucci et al 2 reported successful eradication of H. pylori in 72% of 32 patients with 1‐day quadruple therapy. But Dobrucali et al 3 and de Boer et al 4 got the same lower eradication rate of 57% (26/46, 20/35, respectively) with 1‐day therapy.…”

Is short-term therapy really sufficient to eradicate Helicobacter pylori infection?

“…As mentioned by Tucci et al (1993), the successful outcomes of short-term protocols for H. pylori infection might be attributed to the administration of high-dose drugs or a combination of two antibiotics with one or two non-antibiotic adjunctive agents. It has been reported that the rapid onset of anti-secretory action can potentiate the activity of combined antibiotics after the first day of anti-Helicobacter treatment (Gambaro et al, 2003) and inhibit bacterial urease to a greater degree, which reduces the possibility of H. pylori surviving in the low pH of gastric milieu, and strongly suppresses H. pylori motility.…”

Current Therapy forHelicobacter pyloriInfection in Children and Adolescents

“…If patients discontinue the prescribed medications when symptoms disappear, they will not complete the treatment course required to eradicate their H pylori. Because compliance seems to be a major factor in the successful treatment of H pylori infection, it is of no surprise that investigators have tried to eradicate H pylori with shorter courses of combination therapy (83). However, to date, the optimal duration of therapy has still not been determined.…”