title: [Efficacy of a multistep strategy for Helicobacter pylori eradication: quadruple therapy with omeprazole, metronidazole, tetracycline and bismuth after failure of a combination of omeprazole, clarithromycin and amoxycillin].
abstract: BACKGROUND
  To evaluate the efficacy of a multistep strategy for Helicobacter pylori (HP) eradication.
  
  
  METHODS
  151 patients, with peptic ulcer or chronic gastritis, infected by HP, treated (first-step) with omeprazole (20 mg/12 h), clarithromycin (500 mg/12 h) and amoxycillin (1 g/12 h) for a week (OCA) and second-step (first-step failures) with omeprazole (20 mg/12 h), metronidazole (500 mg/12 h), tetracyclin (500 mg/6 h) and bismuth (120 mg/6 h) for two weeks.
  
  
  RESULTS
  Intention-to-treat analysis, eradication was achieved with OCA in 78.1% (CI 95%: 71.6-84.7) and OMTB in 90.3% (CI 95%: 74.2-98), with an cumulative eradication rate of 96.7% (CI 95%: 92.4-98.9).
  
  
  CONCLUSIONS
  The efficacy of multistep strategy is high. Therapy with OMTB its a good option after failure with OCA.
authors.affiliation: Area Básica de Salud Dr. Carles Ribas. Barcelona. jbaenad@meditex.es
authors.forename: J M
authors.initials: JM
authors.lastname: Baena Díez
authors.forename: C
authors.initials: C
authors.lastname: López Mompó
authors.forename: F
authors.initials: F
authors.lastname: Rams Rams
authors.forename: M
authors.initials: M
authors.lastname: García Lareo
authors.forename: M
authors.initials: M
authors.lastname: Rosario Hernández Ibáñez
authors.forename: J
authors.initials: J
authors.lastname: Teruel Gila
mesh_terms: D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001729:Bismuth / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D013752:Tetracycline / Q000627:therapeutic use; D017211:Treatment Failure
chemical_list: D000897:Anti-Ulcer Agents; D008795:Metronidazole; D013752:Tetracycline; D009853:Omeprazole; D001729:Bismuth