title: Twice-a-day quadruple therapy for eradication of Helicobacter pylori in the elderly.
abstract: BACKGROUND
  Midday and evening twice-a-day quadruple therapy appears to be the most effective therapy for Helicobacter pylori infection in Northern Sardinia, a site where antibiotics resistance is common.
  
  
  OBJECTIVE
  The objective of our study was to estimate the efficacy, side-effects, and compliance of a quadruple therapy containing esomeprazole in a group of dyspeptic elderly patients.
  
  
  METHODS
  Consecutive elderly patients positive for H. pylori infection and not previously treated for eradication were enrolled. Therapy consisted of esomeprazole 20 mg, tetracycline 500 mg, metronidazole 500 mg, and bismuth subcitrate tablets 240 mg, all twice-a-day with the midday and evening meals, for 10 days. Efficacy was evaluated using 13C-urea breath testing. Compliance was assessed after completing treatment and at follow up. Side effects were graded based on daily activities.
  
  
  RESULTS
  Ninety-five dyspeptic patients (range 65-81 years), 52 men and 43 women, were enrolled. The intention-to-treat cure rate was 91% (81 of 89; 95% CI = 88-99%) and, 95% (81 of 85; 95% CI = 83-96%) per-protocol analysis. Compliance was excellent. Mild-moderate side effects occurred in 27 patients.
  
  
  CONCLUSIONS
  Esomeprazole containing quadruple therapy was highly successful for initial eradication of H. pylori in elderly patients.
authors.affiliation: Istituto di Clinica Medica, Università degli Studi di Sassari, Italy. mpdore@uniss.it
authors.forename: Maria Pina
authors.initials: MP
authors.lastname: Dore
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Maragkoudakis
authors.forename: Antonella
authors.initials: A
authors.lastname: Pironti
authors.forename: Vincenza
authors.initials: V
authors.lastname: Tadeu
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Tedde
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Realdi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Delitala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001944:Breath Tests; D004415:Dyspepsia / Q000188:drug therapy / Q000382:microbiology; D064098:Esomeprazole / Q000627:therapeutic use; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000472:pathogenicity; D006801:Humans; D007422:Intestines / Q000473:pathology; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced; D009942:Organometallic Compounds / Q000627:therapeutic use; D010349:Patient Compliance; D011446:Prospective Studies; D013752:Tetracycline / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D009942:Organometallic Compounds; D008795:Metronidazole; D013752:Tetracycline; C002791:bismuth tripotassium dicitrate; D064098:Esomeprazole