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.
Department of Medicine and Geriatrics, Kwong Wah Hospital, Kowloon, Hong Kong, China. maksk@ha.org.hk
Siu-ka
SK
Mak
Ching-kong
CK
Loo
Alfred M C
AM
Wong
Ping-nam
PN
Wong
Kin-yee
KY
Lo
Gensy M W
GM
Tong
Eric K M
EK
Lam
Andrew K M
AK
Wong
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