Seven-day triple therapy with omeprazole, amoxycillin and clarithromycin for Helicobacter pylori infection in haemodialysis patients.
BACKGROUND
Triple therapy is accepted as the treatment of choice for Helicobacter pylori eradication, but there is no consensus on how long the therapy should be maintained in haemodialysis (HD(+)) patients. Our aims in this study were to evaluate the safety and efficacy of the 7-day triple therapy in HD(+) patients.


METHODS
Forty-seven HD(+) and 55 HD(-) patients with dyspepsia underwent endoscopy. The prevalence of H. pylori was detected by Giemsa stain, followed by the urea breath test (UBT). H. pylori(+) patients were scheduled to undergo 7-day triple therapy and the success of eradication was investigated by UBT.


RESULTS
Forty-five (44%) patients were positive for H. pylori. Forty of them underwent triple therapy and 39 (98%) patients completed the treatment. Eradication was successful in 32 (82%) and unsuccessful in 7 (18%) patients. There was no significant difference between these groups in age, gender, endoscopic findings or HD, and only previous treatment was significant for eradication failure by univariate and multivariate logistic regression analysis. Side effects were observed in 2 (15%) of 13 HD(+) and 3 (11%) of 27 HD(-) patients, and one HD(-) patient had to stop medication because of severe nausea and vomiting. The eradication rate was 93% (28/30) in patients without previous treatment. The triple therapy was unsuccessful in 7 patients, and 4 of them again underwent 7-day triple therapy, but all resulted in failure.


CONCLUSIONS
Seven-day triple therapy is safe and effective for primary treatment of H. pylori infection in both HD(+) and HD(-) patients, but a new treatment is necessary for patients with previous treatment.
Tsukada
K
K
Dept. of First Surgery, Gunma University School of Medicine, Ueda Kidney Clinic, Maebashi, Japan. katukada@topaz.ocn.ne.jp
Miyazaki
T
T
Katoh
H
H
Masuda
N
N
Ojima
H
H
Fukai
Y
Y
Nakajima
M
M
Manda
R
R
Fukuchi
M
M
Kuwano
H
H
Tsukada
O
O
D000367:Age Factors; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001944:Breath Tests / Q000379:methods; D017291:Clarithromycin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D006435:Renal Dialysis; D019233:Retreatment; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014508:Urea
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D004791:Enzyme Inhibitors; D000658:Amoxicillin; D014508:Urea; D017291:Clarithromycin; D009853:Omeprazole