Helicobacter pylori eradication with a 7-day low-dose triple therapy in hemodialysis patients.
BACKGROUND
The optimal therapeutic regimen for Helicobacter pylori (H. pylori) infection has not been established in end-stage renal disease (ESRD) patients receiving hemodialysis. We investigated the efficacy and safety of a 7-day omeprazole-based triple therapy with low doses of amoxicillin and clarithromycin (OAC) for eradication of H. pylori infection in ESRD patients receiving hemodialysis.


METHODS
Thirty-three hemodialysis patients and 55 patients with normal renal function underwent upper gastrointestinal endoscopy. For eradication of H. pylori infection, a 7-day triple therapy with low-dose OAC (omeprazole 40 mg daily, amoxicillin 500 mg daily, and clarithromycin 500 mg daily) regimen was used. Four weeks after the completion of the OAC regimen, the success of the H. pylori eradication therapy was determined by histological examination and rapid urease test.


RESULTS
The prevalence of H. pylori infection was 36.4% in hemodialysis patients and 65.5% in non-uremic patients (p = 0.0150). The mean duration of hemodialysis in H. pylori-positive and -negative patients was 56.8 ± 26.9 versus 66.4 ± 26.1 months, respectively (p = 0.3196). Eradication was successful in 83.4% of hemodialysis patients and 81.0% of non-uremic patients (p = 1.000). All patients completed the eradication therapy without any serious adverse effects.


CONCLUSIONS
A 7-day triple therapy with a low-dose OAC regimen was effective and safe for eradication of H. pylori infection in hemodialysis patients.
Chang
Won-Chul
WC
Division of Nephrology, Department of Internal Medicine, Konkuk University Hospital, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea.
Jo
Young-Il
YI
Park
Hyung-Seok
HS
Jegal
Joon
J
Park
Jung-Hwan
JH
Lee
Jong-Ho
JH
Jin
Choon-Jo
CJ
D000368:Aged; D000658:Amoxicillin / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000494:pharmacology / Q000627:therapeutic use; D017291:Clarithromycin / Q000494:pharmacology / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000494:pharmacology / Q000627:therapeutic use; D006435:Renal Dialysis; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole