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Esomeprazole‐based one‐week triple therapy with clarithromycin and metronidazole is effective in eradicating Helicobacter pylori in the absence of antimicrobial resistance
Author(s) -
Miehlke S.,
SchneiderBrachert W.,
Bästlein E.,
Ebert S.,
Kirsch C.,
Haferland C.,
Buchner M.,
Neumeyer M.,
Vieth M.,
Stolte M.,
Lehn N.,
Bayerdörffer E.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01764.x
Subject(s) - esomeprazole , clarithromycin , omeprazole , medicine , metronidazole , helicobacter pylori , gastroenterology , rapid urease test , amoxicillin , regimen , antibacterial agent , antibiotics , microbiology and biotechnology , gastritis , biology
Summary Aim : This study aimed to investigate the effectiveness of a one‐week triple therapy with esomeprazole, clarithromycin and metronidazole for eradication of Helicobacter pylori infection in the absence of antimicrobial resistance. Methods : Patients testing positive for H. pylori susceptible to metronidazole and clarithromycin ( E ‐test) were randomized to receive a one‐week regimen with either esomeprazole 2 × 20 mg or omeprazole 2 × 20 mg in combination with clarithromycin 2 × 250 mg and metronidazole 2 × 400 mg. Follow‐up endoscopy with histology and culture and/or rapid urease test was performed 4–8 weeks after the end of treatment. Results : Eighty patients were randomized. Helicobacter pylori infection was cured in 38/39 patients of the esomeprazole group and 31/33 patients of the omeprazole group (per protocol 97.4% (95% confidence interval [CI], 86.2–99.9), 93.7% (95% CI, 79.2–99.2), P = 0.59); intention‐to‐treat 90.4% (95% CI: 77.4–97.3), 81.6% (95% CI: 65.7–92.3), respectively. No major side effects occurred. Minor side effects occurred in eight (20%) and six (23%) patients during esomeprazole and omeprazole therapy, respectively. Post‐treatment susceptibility testing revealed resistance to both metronidazole and clarithromycin in two of the three patients who failed. Conclusion : We conclude that esomeprazole, clarithromycin and metronidazole as one‐week triple therapy is effective for eradication of H. pylori in the absence of antimicrobial resistance.