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Helicobacter pylori Eradication Regimens: Is there a Difference?
Author(s) -
Khu Jia Vui,
Lim Li Lin
Publication year - 2010
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2010.tb00537.x
Subject(s) - medicine , clarithromycin , metronidazole , helicobacter pylori , omeprazole , amoxicillin , urea breath test , proton pump inhibitor , gastroenterology , rapid urease test , antibiotics , helicobacter pylori infection , microbiology and biotechnology , biology
Background The Singapore Ministry of Health's guidelines for Helicobacter pylori eradication recommend several regimens as first‐line treatment. Aim To evaluate the eradication rates of H. pylori at the National University Hospital with the regimens recommended by the Singapore Ministry of Health's guidelines. Method Single centre retrospective study of patients with H. pylori infection. Patients who had an urea breath test from August 2007 to August 2008 were identified from the hospital's database. Patients were included in the analysis if they were also identified to have had histology and urease tests before and after the H. pylori eradication regimens. Patients' H. pylori eradication regimens were identified and verified from the computerised patient support system and iPharm. Results 802 patients who had an urea breath test during the study period were identified and 337 patients were excluded from the analysis as they did not meet the inclusion criteria. 465 patients were included in the final analysis. Standard triple therapy (amoxycillin, clarithromycin, proton pump inhibitor) yielded an eradication rate of 83% (n = 385), 100% (n = 10) and 78% (n = 18) when given for 7, 10 and 14 days, respectively. Metronidazole‐based triple therapy had a low eradication rate of 48% (n = 29). Quadruple therapy (proton pump inhibitor, bismuth, metronidazole, tetracycline) had an eradication rate of 100% (n = 6) and 75% (n = 8) when used as first‐line and second‐line therapy, respectively. Conclusion Standard triple therapy (clarithromycin, amoxycillin, omeprazole) for 7 days should be considered first‐line. Quadruple therapy (metronidazole, bismuth, tetracycline, omeprazole) should be considered for patients with penicillin and/or clarithromycin allergy and those who fail to eradicate H. pylori with standard triple therapy.