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High‐dose, ten‐day esomeprazole, amoxicillin and metronidazole triple therapy achieves high H elicobacter pylori eradication rates
Author(s) -
SánchezDelgado J.,
GarcíaIglesias P.,
CastroFernández M.,
Bory F.,
Barenys M.,
Bujanda L.,
Lisozain J.,
Calvo M. M.,
Torra S.,
Gisbert J. P.,
Calvet X.
Publication year - 2012
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 - 10.1111/j.1365-2036.2012.05137.x
Subject(s) - esomeprazole , amoxicillin , metronidazole , medicine , helicobacter pylori , gastroenterology , rapid urease test , regimen , breath test , urea breath test , antibiotics , gastritis , microbiology and biotechnology , helicobacter pylori infection , biology
Summary Background Strong acid inhibition using esomeprazole increases cure rates with triple therapy and 10‐day treatments are more effective than 7‐day ones. The combination of amoxicillin plus metronidazole at full doses, and using a physiologically‐correct schedule three times a day, and has been shown to overcome metronidazole resistance and to achieve good eradication rates. Aims To assess the eradication rate of a new first‐line treatment regimen associating strong acid inhibition, amoxicillin and metronidazole and to evaluate tolerance. Methods Patients from eight hospitals were included. H elicobacter pylori status was assessed by at least one of the following: histology, culture, rapid urease test or urea breath test ( UBT ). Ten‐day treatment was prescribed comprising esomeprazole 40 mg twice a day plus amoxicillin 1 g and metronidazol 500 mg both three times a day. H elicobacter pylori cure was assessed by UBT . Results A hundred and thirty‐six patients were enrolled. Mean age was 52.6 ± 16 years and 59.6% of patients were men. Main indications for treatment were: uninvestigated dyspepsia (13.6%); functional dyspepsia (18.2%); gastric ulcer (21.8%); and duodenal ulcer (39.8%). H elicobacter pylori eradication was achieved in 112 of the 127 patients who returned for follow‐up. Eradication rates were 82.4% (95% CI : 74.7–88.1) by intention‐to‐treat analysis and 88.2% (95% CI : 81.2–92.8) by per protocol. Treatment was well tolerated and no major side effects were reported. Nine patients complained of mild side effects. Conclusions Cure rates of the combination of esomeprazole, amoxicillin and metronidazole are high and the treatment was well tolerated. This pilot study warrants the comparison of this schedule with current standards.