Highly effective second-line anti-Helicobacter pylori therapy in patients with previously failed metronidazole-based therapy.
BACKGROUND
In this study we compared the cure rates of two clarithromycin-based regimens in patients in whom anti-Helicobacter pylori therapy had previously failed.


METHODS
Thirty-three patients were randomized to receive either regimen OAC (20 mg omeprazole, 750 mg amoxicillin, and 250 mg clarithromycin) or BTC (240 mg bismuth subcitrate, 750 mg oxytetracycline, and 250 mg clarithromycin), all twice daily for 10 days. A further 28 patients were all treated with OAC. Previously failed therapy included combinations of bismuth (B), omeprazole (O), tetracycline (T), metronidazole (M), amoxicillin (A), or clarithromycin (C) in BTM (n = 48), OAM (n = 13), OA (n = 7), OCM (n = 2), or BCM (n = 1). H. pylori infection was confirmed by culture of biopsy specimens, and antimicrobial susceptibility testing was performed with the E test.


RESULTS
H. pylori infection was cured in all patients (n = 18) with OAC and in 8 patients (53%) with BTC (P = 0.001) in the randomized group and in 27 patients (96%) receiving OAC in the open-label group.


CONCLUSIONS
Ten-day OAC is highly effective and superior to BTC in patients in whom metronidazole-based treatment has previously failed.
Lerang
F
F
Dept. of Internal Medicine, Ostfold Central Hospital, Fredrikstad, Norway.
Moum
B
B
Haug
J B
JB
Berge
T
T
Tolås
P
P
Sandvei
P K
PK
Torp
R
R
Tønnesen
T
T
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D000994:Antitrichomonal Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000008:administration & dosage; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage; D009942:Organometallic Compounds / Q000008:administration & dosage; D010118:Oxytetracycline / Q000008:administration & dosage; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000994:Antitrichomonal Agents; D009942:Organometallic Compounds; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin; C002791:bismuth tripotassium dicitrate; D009853:Omeprazole; D010118:Oxytetracycline