7-Day Nonbismuth-Containing Concomitant Therapy Achieves a High Eradication Rate forHelicobacter pyloriin Taiwan

Background.Ten-day concomitant therapy achieves a high eradication rate in Taiwan. Whether shortening the duration of concomitant therapy can still keep a high eradication rate remains unclear.Aim.To assess the eradication rate of 7-day pantoprazole-containing concomitant therapy in Taiwan and to investigate factors influencing the eradication outcome.Methods.From March 2008 to March 2012, 319H. pylori-infected patients receiving a 7-day pantoprazole-containing concomitant regimen (pantoprazole 40 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily for 7 days) were included. Patients were asked to return at the second week to assess drug compliance and adverse effects. Repeated endoscopy or urea breath test was performed at 8 weeks after the end of eradication therapy.Results.The eradication rates according to intention-to-treat and per-protocol analyses were 93.7% (299/319) and 96.4% (297/308), respectively. Adverse events occurred in 13.2% (42/319) of the patients. The compliance rate was 98.4% (314/319). Multivariate analysis disclosed that poor compliance was the only independent factor influencing the efficacy of anti-H. pyloritherapy with an odds ratio of 0.073 (95% confidence interval, 0.011–0.483).Conclusion.7-day concomitant therapy achieved a very high eradication rate forH. pyloriinfection in Taiwan. Drug compliance was the only clinical factor influencing treatment efficacy.

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Helicobacter pyloriEradication with Either Seven-Day or 10-Day Triple Therapies, and with a 10-Day Sequential Regimen

Canadian Journal of Gastroenterology ◽

10.1155/2006/258768 ◽

2006 ◽

Vol 20 (2) ◽

pp. 113-117 ◽

Cited By ~ 56

Author(s):

Giuseppe Scaccianoce ◽

Cesare Hassan ◽

Alba Panarese ◽

Donato Piglionica ◽

Sergio Morini ◽

...

Keyword(s):

Triple Therapy ◽

Breath Test ◽

Eradication Rate ◽

Urea Breath Test ◽

Cure Rate ◽

Intention To Treat ◽

Significant Difference ◽

Sequential Regimen ◽

H Pylori ◽

Very High

BACKGROUND:Helicobacter pylorieradication rates achieved by standard seven-day triple therapies are decreasing in several countries, while a novel 10-day sequential regimen has achieved a very high success rate. A longer 10-day triple therapy, similar to the sequential regimen, was tested to see whether it could achieve a better infection cure rate.METHODS: Patients with nonulcer dyspepsia andH pyloriinfection were randomly assigned to one of the following three therapies: esomeprazole 20 mg, clarithromycin 500 mg and amoxycillin 1 g for seven days or 10 days, or a 10-day sequential regimen including esomeprazole 20 mg plus amoxycillin 1 g for five days and esomeprazole 20 mg, clarithromycin 500 mg and tinidazole 500 mg for the remaining five days. All drugs were given twice daily.H pylorieradication was checked four to six weeks after treatment by using a13C-urea breath test.RESULTS: Overall, 213 patients were enrolled.H pylorieradication was achieved in 75.7% and 77.9%, in 81.7% and 84.1%, and in 94.4% and 97.1% of patients following seven-day or 10-day triple therapy and the 10-day sequential regimen, at intention-to-treat and per protocol analyses, respectively. The eradication rate following the sequential regimen was higher than either seven-day (P=0.002) or 10-day triple therapy (P=0.02), while no significant difference emerged between the latter two regimens (P=0.6).CONCLUSIONS: The 10-day sequential regimen was significantly more effective than both triple regimens, while 10-day triple therapy failed to significantly increase theH pylorieradication rate achieved by the standard seven-day regimen.

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Dual Therapy with Vonoprazan and Amoxicillin Is as Effective as Triple Therapy with Vonoprazan, Amoxicillin and Clarithromycin for Eradication of Helicobacter pylori

Digestion ◽

10.1159/000502287 ◽

2019 ◽

Vol 101 (6) ◽

pp. 743-751 ◽

Cited By ~ 13

Author(s):

Takahisa Furuta ◽

Mihoko Yamade ◽

Takuma Kagami ◽

Takahiro Uotani ◽

Takahiro Suzuki ◽

...

Keyword(s):

Helicobacter Pylori ◽

Triple Therapy ◽

Eradication Rate ◽

Antimicrobial Agents ◽

Eradication Therapy ◽

Dual Therapy ◽

Urea Breath Test ◽

Intention To Treat ◽

H Pylori ◽

Treat Analysis

Backgrounds/Aims: Vonoprazan (VPZ) is the first clinically available potassium competitive acid blocker. This class of agents provides faster and more potent acid inhibition than proton pump inhibitors. Most strains of Helicobacter pylori are sensitive to amoxicillin. We hypothesized that dual therapy with VPZ and amoxicillin would provide the sufficient eradication rate for H. pylori infection. To evaluate this, we compared the eradication rate by the dual VPZ/amoxicillin therapy with that by the standard triple VPZ/amoxicillin/clarithromycin therapy. Methods: Non-inferiority of the eradication rate of H. pylori by the dual therapy with VPZ 20 mg twice daily (bid) and amoxicillin 500 mg 3 times daily (tid) for 1 week to that by the triple therapy with VPZ 20 mg bid, amoxicillin 750 mg bid and clarithromycin 200 mg bid for 1 week was retrospectively studied. Propensity score matching was performed to improve comparability between 2 regimen groups. Successful eradication was diagnosed using the [13C]-urea breath test at 1–2 months after the end of eradication therapy. Results: The intention-to-treat analysis demonstrated that the eradication rate by the dual therapy (92.9%; 95% CI 82.7–98.0%, 52/56) was not inferior to that of the triple therapy (91.9%; 95% CI 80.4–97.0%, 51/56; OR 1.275, 95% CI 0.324–5.017%, p = 0.728). There were no statistically significant differences in incidences of adverse events between 2 regimens. Conclusion: VPZ-based dual therapy (VPZ 20 mg bid and amoxicillin 500 mg tid for 1 week) provides an acceptable eradication rate of H. pylori infection without the need for second antimicrobial agents, such as clarithromycin.

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Vonoprazan-Based Regimen Is More Useful than PPI-Based One as a First-LineHelicobacter pyloriEradication: A Randomized Controlled Trial

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2017/4385161 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 17

Author(s):

Masafumi Maruyama ◽

Naoki Tanaka ◽

Daisuke Kubota ◽

Masayuki Miyajima ◽

Takefumi Kimura ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Adverse Events ◽

Eradication Rate ◽

Controlled Trial ◽

Eradication Therapy ◽

Group Versus ◽

Intention To Treat ◽

Randomized Controlled ◽

Primary Endpoints ◽

H Pylori

Background. A new agent, potassium-competitive acid blocker vonoprazan (VPZ) has potent acid-inhibitory effects and may offer advantages over conventionalH. pylorieradication therapies. We aimed to compare the eradication rate between VPZ-based treatment and PPI-based one.Methods. This randomized controlled trial was designed to assign 141 patients withH. pylori-positive gastritis to VPZ group (VPZ 20 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days) or PPI group (rabeprazole 20 mg or lansoprazole 30 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days). Primary endpoints were eradication rates and adverse events.Results. Seventy of 72 patients in VPZ group and 63 of 69 patients in PPI group completed the treatment after 7 days. The eradication rate was significantly higher in VPZ group than PPI group by intention-to-treat analysis (95.8% versus 69.6%,P=0.00003, 95% confidence interval [CI] 88.3-99.1% versus 57.3-80.1%) and per-protocol analysis (95.7% versus 71.4%,P=0.0002, 95% CI 88.0-99.1% versus 58.7-82.1%). The incidence of adverse events was not different between the groups (26.3% in VPZ group versus 37.7% in PPI group,P=0.15).Conclusion. VPZ-based regimen is more useful than that PPI-based regimen as a first-lineH. pylorieradication therapy.

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Is Only Clarithromycin Susceptibility Important for the Successful Eradication of Helicobacter pylori?

Antibiotics ◽

10.3390/antibiotics9090589 ◽

2020 ◽

Vol 9 (9) ◽

pp. 589

Author(s):

Young Min Kim ◽

Kyoung Hwa Lee ◽

Jie-Hyun Kim ◽

Soon Young Park ◽

Young Goo Song ◽

...

Keyword(s):

Helicobacter Pylori ◽

Antimicrobial Susceptibility ◽

Eradication Rate ◽

Susceptibility Testing ◽

Eradication Therapy ◽

Antimicrobial Susceptibility Testing ◽

Concomitant Therapy ◽

Standard Triple Therapy ◽

H Pylori

Resistance to clarithromycin and other antibiotics included in the eradication regimen, such as amoxicillin and metronidazole, is important for Helicobacter pylori (H. pylori) eradication. The aim of this study was to investigate the correlation between the results of antimicrobial susceptibility testing and the eradication rate, as well as to understand the importance of antimicrobial susceptibility testing in H. pylori eradication. We retrospectively reviewed the electronic medical records of 1862 patients who underwent gastric biopsy for the culture of H. pylori during upper endoscopy from March 2015 to June 2019. We tried to find a correlation between the results of the antimicrobial susceptibility testing and the eradication rate in patients who received standard triple or concomitant therapy. A total of 247 patients exhibited positive results for culture and underwent antimicrobial susceptibility testing. Of these, 146 received eradication therapy, with follow-up tests after treatment. In the standard triple therapy, patients who were susceptible to both clarithromycin and amoxicillin exhibited significantly higher eradication rates (85.9%) than those susceptible to clarithromycin and resistant to amoxicillin (75.0%) or those resistant to clarithromycin and susceptible to amoxicillin (44.4%) (p = 0.013). In the concomitant therapy, patients who were susceptible to both clarithromycin and metronidazole had significantly higher eradication rates (96.3%) than those susceptible to clarithromycin and resistant to metronidazole (88.9%) or those resistant to clarithromycin and susceptible to metronidazole (50.0%) (p = 0.016). There was a correlation between the results of antimicrobial susceptibility testing and the eradication rate for H. pylori. In addition to clarithromycin, susceptibility to amoxicillin and metronidazole is also important for the successful eradication of H. pylori.

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TWO YEARS FOLLOW UP AFTER ERADICATION THERAPY OF PEPTIC ULCER

International Journal of Current Pharmaceutical Research ◽

10.22159/ijcpr.2020v12i2.37482 ◽

2020 ◽

pp. 28-31

Author(s):

HASSAN KHUDER RAJAB ◽

ALI ESMAIL AL-SNAFI

Keyword(s):

Peptic Ulcer ◽

Eradication Therapy ◽

Endoscopic Examination ◽

Urea Breath Test ◽

Ulcer Recurrence ◽

Follow Up Study ◽

History Of ◽

Second Year ◽

H Pylori

Objective: This study was performed to detect the recurrence rate for two years after eradication therapy of peptic ulcer. Methods: Sixty-nine patients included in this study in Kirkuk city from January 2004 to January 2005 as 1st year follow up, and 49 patients from January 2005 to January 2006 as second year follow up study. A urea breath test and re-endoscopic examination were carried out to confirm peptic ulcer recurrence. A questionnaire was prepared to take the history of the disease and other relevant data of each patient. Results: The recurrence was occurred in 6 (8.7%) and 8 patients (16.33%) in the 1st and 2nd years after eradication therapy. Highly risk of recurrence was smoking, age below 50 y and stress in 1st year follow up, and stress was the highly risk in the 2nd year follow up. Conclusion: After triple and quadruple therapy of peptic ulcer, the recurrence is low, However, the possibility of H. pylori resistance should be considered.

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The efficacy and safety of quadruple therapy without bismuth (concomitant therapy) in the treatment of patients with Helicobacter pylori - associated gastric and duodenal peptic ulcer disease

Terapevticheskii arkhiv ◽

10.26442/00403660.2019.08.000382 ◽

2019 ◽

Vol 91 (8) ◽

pp. 28-33 ◽

Cited By ~ 1

Author(s):

A M Veliev ◽

I V Maev ◽

D N Andreev ◽

D T Dicheva ◽

A V Zaborovskii ◽

...

Keyword(s):

Duodenal Ulcer ◽

Helicobacter Pylori ◽

Side Effects ◽

Triple Therapy ◽

Eradication Therapy ◽

Test System ◽

Efficacy And Safety ◽

Concomitant Therapy ◽

Quadruple Therapy ◽

H Pylori

Aim. Evaluation of the efficacy and safety of quadrupletherapy without bismuth (concomitant therapy) in patients with Helicobacter pylori - associated gastric ulcer and duodenal ulcer in the framework of a comparative research in the population of patients in Russia. Materials and methods. A prospective randomized trial was conducted, which included 210 patients with H. pylori - associated gastric/duodenal ulcer without complications. During the process of randomization, the patients were divided into three equal groups (n=70) depending on the prescribed 10-day scheme of eradication therapy (ET): the first group received the classic triple scheme (Omeprazole 20 mg 2 times a day, Amoxicillin 1000 mg 2 times a day and Clarithromycin 500 mg 2 times a day); the second group received quadruple therapy with bismuth drugs (Omeprazole 20 mg 2 times a day, Tetracycline 500 mg 4 times a day, Metronidazole 500 mg 3 times a day, Bismuth subcitrate potassium 120 mg 4 times a day); the third group received quadruple therapy without bismuth - concomitant therapy (Omeprazole 20 mg 2 times a day, Amoxicillin 1000 mg 2 times a day, Clarithromycin 500 mg 2 times a day and Metronidazole 500 mg 2 times a day). Diagnostics of H. pylori infection during screening and control of eradication was carried out via the fast urease biopsy sample test and urea breath test system. Control of the effectiveness of ET of the microorganism was carried out not earlier than 4 weeks after the end of the treatment. During the course of therapy, the frequency of development of side effects was assessed using a special questionnaire. Results and discussion. The effectiveness of triple therapy was 72.8% (ITT; 95% CI of 62.17-83.54) and 78,4% (PP; 95% CI 68.19-88.72); quadruple therapy with the preparation of bismuth - 80.0% (ITT; 95% CI 70.39-89.6) and 84,8% (PP; 95% CI, 75.96-93.73); quadruple therapy without bismuth - concomitant therapy - 84.2% (ITT; 95% CI 75.54-93.02) and 92.1% (PP; 95% CI 85.43-98.94). Quadruple therapy without bismuth was reliably more effective than the classical triple therapy in the PP selection (p=0.044883). Statistical analysis showed a tendency to poorer effectiveness of ET in patients who had previously used antibiotic therapy (OR 0.4317; 95% CI 0.1776-1.049), and in individuals with a rapid metabolism genotype - CYP2C19*1/*1 (OR 0.12; 95% CI 0.005848-2.4624). The frequency of development of side effects during the use of triple therapy was 18.5% (95% CI of 9.23-27.91), when using quadruple therapy with bismuth - 20.0% (95% CI 10.39-29.6), and with the use of quadruple therapy without bismuth - concomitant therapy - 24.2% (95% CI 13.98-34.58). Conclusion. This prospective randomized study demonstrated the high efficiency of quadruple therapy without bismuth (concomitant therapy) in the framework of eradication of H. pylori infection in Russia.

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Helicobacter pylori causes gastrointestinal hemorrhage in patients with congenital bleeding disorders

Thrombosis and Haemostasis ◽

10.1055/s-0037-1613581 ◽

2003 ◽

Vol 89 (04) ◽

pp. 741-746 ◽

Cited By ~ 7

Author(s):

Ann-Sofie Rehnberg ◽

Marju Hein ◽

Olga Hegedus ◽

Per Lindmarker ◽

Per Hellström ◽

...

Keyword(s):

Helicobacter Pylori ◽

Gastrointestinal Hemorrhage ◽

Breath Test ◽

Eradication Therapy ◽

Urea Breath Test ◽

Von Willebrand Disease ◽

Bleeding Disorders ◽

Ulcer Disease ◽

H Pylori ◽

One Year

Summary Helicobacter pylori (H. pylori) infection is associated with peptic ulcer disease and gastric cancer. The eradication of H. pylori is of special interest in patients with congenital bleeding disorders, for whom treatment of gastrointestinal hemorrhage with factor concentrates is costly. The prevalence of H. pylori varies between different populations and identification of high-risk subgroups may allow for more targeted screening and eradication of the infection. We performed a 5-year retrospective study of gastrointestinal bleeding, combined with screening and treatment for H. pylori and a long-term prospective follow-up in 168 Swedish and 23 Estonian patients with hemophilia or von Willebrand disease. The prevalence of seropositivity was lower in Sweden than in Estonia (28 versus 48%, p = 0.03), lower in native Swedes than in non-Nordic immigrants to Sweden (20 versus 76%, p = 0.0001) and lower in patients less than 40 years of age than older patients (16 versus 38%, p = 0.002). The incidence of gastrointestinal hemorrhages among the 35 Swedish patients with active H. pylori infection, confirmed by a urea breath test, was 6.0 per 100 patient-years before eradication therapy versus 1.7 during the prospective followup. A negative urea breath test one month after therapy always remained negative after one year. Screening, followed by treatment of all infected patients, yielded a reduction of direct costs over a 5-year period of 130 US-$ per screened patient. We conclude that screening and eradication therapy for infection with H. pylori in patients with congenital bleeding disorders is an effective and economic strategy.

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A 14-Day Course of Triple Therapy is Superior to a 10-Day Course for the Eradication ofHelicobacter pylori: A Canadian Study Conducted in a ‘Real World’ Setting

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2015/659390 ◽

2015 ◽

Vol 29 (8) ◽

pp. e7-e10 ◽

Cited By ~ 6

Author(s):

Yen-I Chen ◽

Carlo A Fallone

Keyword(s):

Triple Therapy ◽

Eradication Rate ◽

Day Treatment ◽

Office Visit ◽

First Line ◽

Intention To Treat ◽

Treatment Naïve ◽

Gastric Biopsies ◽

H Pylori ◽

Treat Analysis

BACKGROUND: SuccessfulHelicobacter pylorieradication with the traditional seven-day course of proton pump inhibitor (PPI) triple therapy is declining. Prolonging therapy to either 10 or 14 days is associated with better eradications rates.OBJECTIVE: To compare the effectiveness of 14-day course of triple therapy versus a 10-day course in the treatment ofH pyloriin Canada.METHODS: Consecutive treatment-naive patients with clinical indications forH pylorieradication underwent either a 10-day course or a 14-day course of traditional PPI triple therapy depending on the date of the office visit (an odd date received the 10-day course, whereas an even date received the 14-day treatment).H pylorieradication was ascertained via urea breath test or gastric biopsies performed ≥4 weeks after completion of therapy. Analyses were by both intention to treat and per-protocol.RESULTS: A total of 83 patients were included in the study (31 in the 10-day group and 52 in the 14-day group). In the intention-to-treat analysis, eradication rates were 82.7% (95% CI 70% to 92%) versus 45.2% (95% CI 27% to 64%), favouring the 14-day treatment (P<0.001). Similarly, in the per-protocol analysis, eradication rates were 91.5% (95% CI 80% to 98%) versus 63.6% (95% CI 41% to 83%), favouring the 14-day arm (P=0.01). Adverse events and compliance were not significantly different between the two groups.CONCLUSION: A 14-day course of standard PPI triple therapy was superior to a shorter-duration therapy and should be included as a first-line regimen forH pylorieradication in Canada. The 10-day course of treatment did not achieve an acceptable eradication rate and should no longer be used in this country.

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Eradication Rate of H. pylori After Therapy Based on Urea Breath Test: A Single-Center Study on the U.S.-Mexico Border

The American Journal of Gastroenterology ◽

10.14309/00000434-201610001-01143 ◽

2016 ◽

Vol 111 ◽

pp. S498

Author(s):

Roy Liu ◽

Roberta Romero ◽

Jerzy Sarosiek ◽

Alok Dwivedi ◽

Christopher Dodoo ◽

...

Keyword(s):

Breath Test ◽

Eradication Rate ◽

Urea Breath Test ◽

Single Center ◽

Single Center Study ◽

Mexico Border ◽

H Pylori ◽

The U.S ◽

Center Study

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Efficacy of Levofloxacin Based Triple and High-Dose PPI-Amoxicillin Dual Eradication Therapy for Helicobacter pylori after Failures of First- and Second-Line Therapies

International Scholarly Research Notices ◽

10.1155/2014/631501 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Kenichiro Okimoto ◽

Makoto Arai ◽

Keiko Saito ◽

Shoko Minemura ◽

Daisuke Maruoka ◽

...

Keyword(s):

Helicobacter Pylori ◽

Triple Therapy ◽

Eradication Rate ◽

Eradication Therapy ◽

High Dose ◽

Second Line ◽

Intention To Treat ◽

The Third ◽

Significant Difference ◽

Third Line

Objectives. The aim of this study was to investigate and compare the eradication rate of Helicobacter pylori as the third-line triple therapy with rabeprazole (RPZ) + amoxicillin (AMPC) + levofloxacin (LVFX) and high-dose RPZ + AMPC. Methods. 51 patients who failed Japanese first-line (proton pump inhibitor (PPI) + AMPC + clarithromycin) and second-line (PPI + AMPC + metronidazole) eradication therapy were randomly assigned at a 1 : 1 ratio to one of the following third-line eradication groups: (1) RAL group: RPZ 10 mg (b.i.d.), AMPC 750 mg (b.i.d.), and LVFX 500 mg (o.d.) for 10 days; (2) RA group: RPZ 10 mg (q.i.d.) and AMPC 500 mg (q.i.d.) for 14 days. Patients who failed to respond to third-line eradication therapy received salvage therapy. Results. The rates of eradication success, based on intention to treat (ITT) analysis, were 45.8% in the RAL group and 40.7% in the RA group. The overall eradication rates were 73.9% in the RAL group and 64.0% in the RA group. There was no significant difference between the two groups. Conclusions. The third-line triple therapy with RPZ, AMPC, and LVFX was as effective as that with high-dose RPZ and AMPC.

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