Efficacy of Helicobacter pylori eradication therapies: a single centre observational study

Beales, ILP (2001) Efficacy of Helicobacter pylori eradication therapies: a single centre observational study. BMC Gastroenterology, 1 (7). ISSN 1471-230X

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Abstract

Background: Many Helicobacter pylori eradication regimens have been described. There are little data reporting their efficacy or integration in routine clinical practice. The overall results of eradication therapy in a cohort of patients are described and an algorithm for management outlined. Methods: 469 patients receiving eradication therapy in routine clinical practice were evaluated. The successes of individual regimes as first, second and third line therapy were determined. Results: Overall success after one, two and three courses of therapy were 73% (95% confidence intervals 69–77%), 94% (91–96%) and 98% (97–99%) respectively. 10 different regimens, including many non-recommended ones were used as primary therapy. Ranitidine bismuth citrate-amoxicillin-clarithromycin triple therapy (94.8%, 90–99%) was significantly more effective than any other combination as primary therapy, including all proton pump inhibitor based triple therapies. Quadruple therapy with bismuth chelate-proton pump inhibitor-tetracycline and a nitroimidazole (70%, 52–88%) and ranitidine bismuth citrate-based triple therapy (73%, 56–90%) where more effective second line combinations than proton pump inhibitor-triple therapies (37.5%, 12–58%). Third line therapy directed by the results of sensitivity testing improved eradication compared to further empirical antibiotics. The use of a proton pump inhibitor with clarithromycin and a nitroimidazole as initial therapy was associated with a significantly worse overall eradication rate than other combinations. Conclusions: Helicobacter pylori eradication rates can be maximised by using ranitidine bismuth citrate-clarithromycin-amoxicillin containing triple therapy, followed by bismuth and nitroimidazle containing second-line therapy, with third line combinations directed by sensitivity testing. Proton pump inhibitor-clarithromycin-metronidazole combinations should be avoided.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
University of East Anglia > Faculty of Medicine and Health Sciences > Research Groups > Gastroenterology and Gut Biology
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Depositing User: EPrints Services
Date Deposited: 25 Nov 2010 11:09
Last Modified: 25 Jul 2018 07:39
URI: https://ueaeprints.uea.ac.uk/id/eprint/12187
DOI: 10.1186/1471-230X-1-7

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