TY - JOUR
T1 - High dose amoxicillin-based first line regimen is equivalent to sequential therapy in the eradication of H. pylori infection
AU - Franceschi, Francesco
AU - Ojetti, Veronica
AU - Scaldaferri, Franco
AU - Gasbarrini, Antonio
AU - Gabrielli, Maurizio
AU - Tortora, Annalisa
AU - Gasbarrini, Giovanni Battista
PY - 2016
Y1 - 2016
N2 - Abstract
OBJECTIVE:
Helicobater (H.) pylori eradication rates with standard first-line triple therapy have declined to unacceptable levels. To date, amoxicillin-resistant H. pylori strains have rarely been detected. Whether increasing the dosage of amoxicillin in a standard 7 days eradicating regimen may enhance its efficacy is not known. The aim of this paper is to compare the efficacy of a 7 days high-dose amoxicillin based first-line regimen with sequential therapy.
PATIENTS AND METHODS:
We have retrospectively analyzed data from 300 sex and age matched patients, who underwent 3 different therapeutic schemes: (1) standard LCA, lansoprazole 30 mg bid, clarithromycin 500 mg bid and amoxicillin 1000 mg bid for 7 days; (2) high dose LCA (HD-LCA), lansoprazole 30 mg bid, clarithromycin 500 mg bid and amoxicillin 1000 mg tid for 7 days; (3) sequential LACT, lansoprazole 30 mg bid plus amoxicillin 1000 mg bid for 5 days, followed by lansoprazole 30 mg bid, clarithromycin 500 mg bid and tinidazole 500 mg bid for 5 days. Eradication was confirmed by 13C-urea breath test. Compliance and occurrence of adverse effects were also assessed.
RESULTS:
Eradication rates were: 55% for LCA, 75% for HD-LCA and 73% for LACT. Eradication rates were higher in HD-LCA group compared to LCA (p<0.01), while no significant differences were observed in HD-LCA group compared to LACT (p=ns). Compliance and occurrence of adverse effects were similar among groups.
CONCLUSIONS:
High-dose amoxicillin based eradicating treatment is superior to standard triple therapy and equivalent to sequential therapy; compared to the latter, the shorter duration may represent an advantage.
AB - Abstract
OBJECTIVE:
Helicobater (H.) pylori eradication rates with standard first-line triple therapy have declined to unacceptable levels. To date, amoxicillin-resistant H. pylori strains have rarely been detected. Whether increasing the dosage of amoxicillin in a standard 7 days eradicating regimen may enhance its efficacy is not known. The aim of this paper is to compare the efficacy of a 7 days high-dose amoxicillin based first-line regimen with sequential therapy.
PATIENTS AND METHODS:
We have retrospectively analyzed data from 300 sex and age matched patients, who underwent 3 different therapeutic schemes: (1) standard LCA, lansoprazole 30 mg bid, clarithromycin 500 mg bid and amoxicillin 1000 mg bid for 7 days; (2) high dose LCA (HD-LCA), lansoprazole 30 mg bid, clarithromycin 500 mg bid and amoxicillin 1000 mg tid for 7 days; (3) sequential LACT, lansoprazole 30 mg bid plus amoxicillin 1000 mg bid for 5 days, followed by lansoprazole 30 mg bid, clarithromycin 500 mg bid and tinidazole 500 mg bid for 5 days. Eradication was confirmed by 13C-urea breath test. Compliance and occurrence of adverse effects were also assessed.
RESULTS:
Eradication rates were: 55% for LCA, 75% for HD-LCA and 73% for LACT. Eradication rates were higher in HD-LCA group compared to LCA (p<0.01), while no significant differences were observed in HD-LCA group compared to LACT (p=ns). Compliance and occurrence of adverse effects were similar among groups.
CONCLUSIONS:
High-dose amoxicillin based eradicating treatment is superior to standard triple therapy and equivalent to sequential therapy; compared to the latter, the shorter duration may represent an advantage.
KW - Adult
KW - Amoxicillin
KW - Anti-Bacterial Agents
KW - Breath Tests
KW - Clarithromycin
KW - Drug Administration Schedule
KW - Drug Therapy, Combination
KW - Female
KW - Helicobacter Infections
KW - Helicobacter pylori
KW - Humans
KW - Lansoprazole
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Adult
KW - Amoxicillin
KW - Anti-Bacterial Agents
KW - Breath Tests
KW - Clarithromycin
KW - Drug Administration Schedule
KW - Drug Therapy, Combination
KW - Female
KW - Helicobacter Infections
KW - Helicobacter pylori
KW - Humans
KW - Lansoprazole
KW - Male
KW - Middle Aged
KW - Retrospective Studies
UR - http://hdl.handle.net/10807/94195
M3 - Article
VL - 20
SP - 297-300-N/A
JO - European Review for Medical and Pharmacological Sciences
JF - European Review for Medical and Pharmacological Sciences
SN - 1128-3602
ER -