title: Miocamycin-containing triple therapy for H. pylori infection.
abstract: BACKGROUND
  In Northern Sardinia, one-week triple standard therapies containing a proton-pump inhibitor and two antibiotics for H. pylori infection have an average cure rate of 57% largely due to a high prevalence of antimicrobial resistance. The efficacy of miocamycin-containing treatment for 10 days was evaluated.
  
  
  METHODS
  Patients referred to the endoscopy service for dyspeptic symptoms were enrolled. H. pylori infection was defined as a positive rapid urease test, presence of the bacteria on gastric biopsies, and a positive 13C-UBT. Treatment consisted of 10 days with omeprazole 20 mg, miocamycin water-soluble 900 mg, and tinidazole 500 mg all bid. Success was evaluated 40-50 days after the end of therapy and defined by a negative 13C-UBT. Compliance was considered good if at least 90% of the total number of the pills were taken. Fluorescent in situ hybridization (FISH) technique was applied on paraffin-embedded gastric tissue sections to test susceptibility to clarithromycin of the bacteria.
  
  
  RESULTS
  50 patients were enrolled (mean age; 52, 36% men). Miocamycin-containing therapy cured 86% (42/49; 95% CI = 72-94%) of infected patients by PP analysis. Susceptibility data (FISH) was available for 38 patients. Cure rates for the 28 with clarithromycin-susceptible infection was 96% vs 50% for those with resistant or mixed infection, (p = .003). Good compliance was recorded in 48 patients. None of the patients discontinued therapy.
  
  
  CONCLUSIONS
  Miocamycin appears to be a valid alternative for clarithromycin for H. pylori eradication. Head-to-head studies will be needed to ascertain whether it is superior.
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Sassari, Italy. mpdore@uniss.it
authors.forename: Maria Pina
authors.initials: MP
authors.lastname: Dore
authors.forename: Marco
authors.initials: M
authors.lastname: Massidda
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yilmaz
authors.forename: Ebru
authors.initials: E
authors.lastname: Demiray-Gürbüz
authors.forename: Alessandra
authors.initials: A
authors.lastname: Manca
authors.forename: Gabrio
authors.initials: G
authors.lastname: Bassotti
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001944:Breath Tests; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007558:Italy; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D008875:Middle Aged; D015644:Miocamycin / Q000008:administration & dosage*; D010865:Pilot Projects; D016896:Treatment Outcome; D014508:Urea / Q000032:analysis
chemical_list: D000900:Anti-Bacterial Agents; D015644:Miocamycin; D014508:Urea