Efficacy of a 1-week course of proton-pump inhibitor-based triple therapy for eradicating Helicobacter pylori in patients with and without chronic renal failure.
BACKGROUND
The efficacy of short-course triple therapy for the eradication of Helicobacter pylori has been documented in patients with normal renal function. We evaluated the efficacy and safety of a 1-week proton-pump inhibitor-based triple therapy for H pylori eradication in a prospective study of patients with chronic renal failure (CRF).


METHODS
Forty-two patients with a creatinine clearance (CrCl) less than 30 mL/min/1.73 m2 or serum creatinine level greater than 2.26 mg/dL (>200 micromol/L; n = 21; CRF group; 12 patients on dialysis therapy) or normal renal function (n = 21; controls) were studied when they had H pylori infection on top of peptic ulcer disease (20 patients) or gastritis (22 patients). The combination of omeprazole, 20 mg twice daily; amoxicillin, 1 g twice daily; and clarithromycin, 500 mg twice daily, was administered for 1 week. All patients underwent repeated endoscopy 4 weeks later for assessment of eradication. Apart from patients on dialysis therapy, all patients had serum creatinine levels and CrCls measured 2 and 4 weeks after treatment.


RESULTS
All except 5 patients (2 patients, CRF group; 3 controls) had successful eradication (90.5% versus 85.7%). For patients not on dialysis therapy, serum creatinine levels and CrCls remained stable 4 weeks after treatment (serum creatinine, 3.68 +/- 1.09 versus 3.76 +/- 1.09 mg/dL [325 +/- 96 versus 332 +/- 96 micromol/L]; P = not significant [NS]; CrCl, 21.4 +/- 8.3 versus 22.2 +/- 6.9 mL/min/1.73 m2; P = NS).


CONCLUSIONS
The 1-week course of proton-pump inhibitor-based triple therapy achieved a high eradication rate of H pylori infection in patients with CRF, similar to controls with normal renal function. The regimen was well tolerated.
Mak
Siu-ka
SK
Department of Medicine and Geriatrics, Kwong Wah Hospital, Kowloon, Hong Kong, China. maksk@ha.org.hk
Loo
Ching-kong
CK
Wong
Alfred M C
AM
Wong
Ping-nam
PN
Lo
Kin-yee
KY
Tong
Gensy M W
GM
Lam
Eric K M
EK
Wong
Andrew K M
AK
D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D015738:Famotidine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000188:drug therapy / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D015738:Famotidine; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole