Randomized comparison of differing periods of twice‐a‐day triple therapy for the eradication of Helicobacter pylori

Laine, Loren; Estrada, Roque; Trujillo, Mónica; Fukanaga, K.; Neil, Garry A.

doi:10.1046/j.1365-2036.1996.111282000.x

Cited by 93 publications

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“…Our eradication rate of about 86% with 1-week treatment using a combination of two antibiotics and a proton pump inhibitor compares favourably with results from other studies which used similar 1-week regimens from Europe [12,13], China [14], Turkey [15] and USA [16]. In these studies too, the rates of H. pylori eradication were not significantly higher with prolonged treatment compared to treatment for 1 week.…”

Section: Discussionsupporting

confidence: 76%

Comparison of one week and two weeks of triple therapy for the eradication of Helicobacter pylori in a Sri Lankan population: a randomised, controlled study

Silva¹,

Hewavisenthi

Pathmeswaran³

et al. 2010

Ceylon Med. J.

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Section: Discussionsupporting

confidence: 76%

Comparison of one week and two weeks of triple therapy for the eradication of Helicobacter pylori in a Sri Lankan population: a randomised, controlled study

Silva¹,

Hewavisenthi

Pathmeswaran³

et al. 2010

Ceylon Med. J.

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“…Recent results from Laine et al showed that the cure rate increased as the duration of therapy was increased from 7 to 14 days. 28 In our own study we had a relative low cure rate with omeprazole±clarithro-mycin±amoxycillin administered for 1 week (77% intention-to-treat). 29 Clearly, multicentre head-to-head comparisons are needed to address the best dosages, duration and proton pump inhibitor vs. H 2 -receptor antagonist antisecretory therapy.…”

Section: Discussionmentioning

confidence: 94%

Clarithromycin, amoxycillin and H₂‐receptor antagonist therapy for Helicobacter pylori peptic ulcer disease in Korea

Breuer

Kim

El‐Zimaity

et al. 1997

Aliment Pharmacol Ther

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Background: Effective anti‐Helicobacter pylori therapies with few side‐effects are needed. We previously showed that the regimen of amoxycillin, clarithromycin and an H2‐receptor antagonist was effective in the United States. The current study tested whether this therapy would also be successful in Korea. Methods: Patients with gastric or duodenal ulcers received amoxycillin (750 mg t.d.s.) plus clarithromycin (500 mg t.d.s.) for 2 weeks and nizatidine 300 mg at bedtime for 6 weeks. Endoscopic examinations were performed before treatment and 4 or more weeks after ending antimicrobial therapy. H. pylori status was confirmed by rapid urease testing and histological examination of gastric antrum and corpus biopsies using the Genta stain. Antibiotic resistance was tested using the E‐test method. Cure was defined as no evidence of H. pylori infection 4 or more weeks after ending therapy. Results: Seventy‐two patients (59 males and 13 females; mean age 46 years), including 35 with duodenal ulcers, 30 with gastric ulcers and seven with both, were studied. H. pylori infection was cured in 95.8% (69/72 patients; 95% CI = 88.3–99.1%). Two of the treatment failures had culture data and one had pre‐treatment resistance to clarithromycin. Smoking did not have an adverse effect on therapy. Ten patients (15%) developed side‐effects during treatment, but all were mild and did not require treatment interruption. No case of reinfection was noted during follow‐up. Conclusion: The combination of amoxycillin, clarithromycin and an H2‐receptor antagonist is effective in Korean patients with H. pylori infection.

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“…However, early reports in US patients have not been able to demonstrate eradication rates of 90% or higher. A recent randomized comparison of 7, 10 and 14 days of proton pump inhibitorbased triple therapy in 150 patients 9 found an 86% eradication rate (intention-to-treat and per-protocol) with 7 days of treatment, and a 92% intention-to-treat rate with 14 days of therapy (per-protocol rate, 95%). Yous® et al 10 found only a 77% intention-to-treat eradication rate (per-protocol rate, 79%) for 31 patients treated with 1 week of twice-daily omeprazole, amoxycillin and clarithromycin (250 mg), while preliminary results from Schwartz et al 11 showed only a 68% intention-to-treat eradication rate (per-protocol rate, 78%) in 59 patients treated with twice-daily lansoprazole, metronidazole and clarithromycin (500 mg).…”

Section: Discussionmentioning

confidence: 99%

A United States multicentre trial of dual and proton pump inhibitor‐based triple therapies for Helicobacter pylori

Laine¹,

Frantz²,

Baker³

et al. 1997

Aliment Pharmacol Ther

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Background: One‐week proton pump inhibitor‐based triple therapies are very popular in the US despite limited US data documenting efficacy. We assessed 1‐week proton pump inhibitor triple therapies for Helicobacter pylori, and compared them to dual antibiotic therapies (to assess benefit of omeprazole) and to omeprazole–amoxycillin (to assess benefit of clarithro‐ mycin) in a large, randomized, US multicentre study. Methods: Healthy subjects who were H. pylori‐positive by rapid serological test and 13C‐urea breath test were randomly assigned to (i) omeprazole (O) 20 mg b.d. + amoxycillin (A) 1 g t.d.s. for 14 days (OA); (ii) A 1 g b.d. + clarithromycin (C) 500 mg b.d. for 7 days (AC); (iii) C 250 mg b.d. + metronidazole (M) 500 mg b.d. for 7 days (CM); (iv) O 20 mg b.d. + C 250 mg b.d. + M 500 mg b.d. for 7 days (MOC); or (v) O 20 mg b.d. + C 500 mg b.d. + A 1 g b.d. for 7 days (OAC). Repeat breath tests were done at 6 weeks to assess H. pylori status. Results: Three hundred and two H. pylori‐positive subjects at 25 centres received medication. Intention‐to‐treat cure rate was significantly higher for OAC (82%) than for MOC (67%), CM (59%), AC (18%) or OA (58%). Per‐protocol cure rates were 85% for OAC and 75% for MOC. Discontinuation of therapy due to a side‐effect occurred in 0–3% of each study group. Conclusions: One‐week twice‐daily triple therapy with omeprazole, amoxycillin and clarithromycin provides the best rate of eradication of the five regimens studied. However, treatment in the US for 7 days may be unable to achieve eradication rates of ≥ 90% with proton pump inhibitor‐based triple therapy.

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Randomized comparison of differing periods of twice‐a‐day triple therapy for the eradication of Helicobacter pylori

Cited by 93 publications

References 0 publications

Comparison of one week and two weeks of triple therapy for the eradication of <i>Helicobacter pylori</i> in a Sri Lankan population: a randomised, controlled study

Comparison of one week and two weeks of triple therapy for the eradication of <i>Helicobacter pylori</i> in a Sri Lankan population: a randomised, controlled study

Clarithromycin, amoxycillin and H₂‐receptor antagonist therapy for Helicobacter pylori peptic ulcer disease in Korea

A United States multicentre trial of dual and proton pump inhibitor‐based triple therapies for Helicobacter pylori

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Randomized comparison of differing periods of twice‐a‐day triple therapy for the eradication of Helicobacter pylori

Cited by 93 publications

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Comparison of one week and two weeks of triple therapy for the eradication of <i>Helicobacter pylori</i> in a Sri Lankan population: a randomised, controlled study

Comparison of one week and two weeks of triple therapy for the eradication of <i>Helicobacter pylori</i> in a Sri Lankan population: a randomised, controlled study

Clarithromycin, amoxycillin and H2‐receptor antagonist therapy for Helicobacter pylori peptic ulcer disease in Korea

A United States multicentre trial of dual and proton pump inhibitor‐based triple therapies for Helicobacter pylori

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Clarithromycin, amoxycillin and H₂‐receptor antagonist therapy for Helicobacter pylori peptic ulcer disease in Korea