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  • 1
    Electronic Resource
    Electronic Resource
    Equally high efficacy of 4, 7 and 10-day triple therapies to eradicate Helicobacter pylori infection in patients with ulcer disease (2000)
    Oxford UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 14 (2000), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In patients with ulcer disease the optimal dose and duration of Helicobacter pylori treatment containing omeprazole (O), metronidazole (M) and clarithromycin (C) has yet to be established. The efficacy might be influenced by metronidazole- and clarithromycin-resistance.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To study the effect of duration of OMC treatment on its efficacy and influence of metronidazole-resistance and clarithromycin-resistance on the optimal duration.〈section xml:id="abs1-3"〉〈title type="main"〉Materials and methods:Ulcer patients (n=76) were randomized to three double-blind treatments of 10 days: OMC 4 consisted of 4 days b.d. 20 mg omeprazole, 400 mg metronidazole and 250 mg clarithromycin switched over to 6 days b.d. 20 mg omeprazole and placebo antibiotics (n=27); OMC 7 consisted of 7 days b.d. omeprazole 20 mg, metronidazole 400 mg and clarithromycin 250 mg and 3 days b.d. omeprazole 20 mg and placebo antibiotics (n=25); OMC 10 consisted of 10 days b.d. omeprazole 20 mg, metronidazole 400 mg and clarithromycin 250 mg (n=24). H. pylori was assessed by biopsies for culture and histology pre- and 4–6 weeks after OMC therapy. Metronidazole-resistance and clarithromycin-resistance were assessed by the E-test.〈section xml:id="abs1-4"〉〈title type="main"〉Results:Intention-to-treat-eradication rates were: OMC 4, 96%; OMC 7, 92%; and OMC 10, 96% (N.S.). All of the three per protocol eradication rates were 100% (95% CI: 85.2–100). Of 75 isolates, 16 were metronidazole-resistant and one was clarithromycin-resistant.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusion:In H. pylori-positive ulcer patients, OMC 4 is highly efficacious and as effective as OMC 7 and OMC 10. No influence of metronidazole-resistance or clarithromycin-resistance was observed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2000.00800.x
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  • 2
    Electronic Resource
    Electronic Resource
    Reinfection versus recrudescence in Helicobacter pylori infection (1997)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 11 (1997), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Antimicrobial treatment of Helicobacter pylori is the proper management strategy in patients with ulcers. A high rate of H. pylori reinfection after successful eradication therapy however, may give rise to ulcer recurrence. The risk of reinfection, depending on the prevalence and the rate of acquisition of H. pylori infection, varies with socioeconomic status, age and geographical location. The rate of reinfection may vary in a similar way. The available data in the literature reveal that reinfection by H. pylori is low or absent in developed countries and may be lower than the initial rate of acquisition. In addition, reported cases of H. pylori reinfection are often cases of recrudescent H. pylori infection. Acquisition rate in developing countries is high, so the reinfection rate is expected to be higher than in developed countries. However, studies discriminating reinfection from recrudescence are lacking and therefore more data from developing regions are needed to settle if ‘cured once, cured forever’ holds true.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.11.s1.10.x
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  • 3
    Electronic Resource
    Electronic Resource
    Treatment of Helicobacter pylori infection with low or high dose omeprazole combined with amoxycillin and the effect of early retreatment (1996)
    Oxford BSL : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 10 (1996), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Cure rates of H. pylori infection, using dual therapy with omeprazole and amoxycillin, vary considerably and the efficacy of retreatment with this regimen in the case of initial failure is controversial. Therefore, we conducted a large prospective double-blind randomized trial, studying the efficacy of low vs. high dose omeprazole in dual therapy and of early retreatment with the same regimens. Methods: One hundred and sixty-eight consecutive H. pylori-positive patients, suffering from either peptic ulcer disease or functional dyspepsia, were enrolled. Group I (n=84) received omeprazole 20 mg b.d. plus amoxycillin 750 mg t.d.s., for 2 weeks. Group II (n=84) received omeprazole 40 mg t.d.s. plus amoxicillin 750 mg t.d.s., for 2 weeks. Results: The H. pylori eradication rate was 60.2% in group I and 64.3% in group II (P=0.59). Cure of H. pylori infection was significantly better in patients with peptic ulcer disease, compared to non-ulcer dyspeptics (P=0.016). Retreatment, given in 54 patients, was successful in 21.4% patients in group I and in 28% patients in group II (P=0.58). Conclusions: High dose of omeprazole has no advantage compared to low dose in terms of eradication efficacy. Early retreatment with the same regimen offers limited improvement in cure rate. Presence of peptic ulcer disease influences cure rates significantly.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.1996.715895000.x
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  • 4
    Electronic Resource
    Electronic Resource
    Arrest of chronic acid suppressant drug use after successful Helicobacter pylori eradication in patients with peptic ulcer disease: a six-month follow-up study (2001)
    Oxford UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 15 (2001), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: It remains controversial whether successful H. pylori eradication leads to relief of dyspepsia and the subsequent arrest or tapering of acid-suppressant drug therapy, or to an aggravation of acid-related dyspepsia requiring more acid-suppressant drug intake.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To evaluate prospectively the effect of H. pylori eradication on the requirement of acid-suppressant drug or antacids and the evolution of dyspeptic symptoms in chronic acid-suppressant drug users with peptic ulcer disease.〈section xml:id="abs1-3"〉〈title type="main"〉Materials and methods:The use of acid-suppressant drugs, rescue antacids and predominant symptoms were recorded prospectively during 24 weeks after H. pylori eradication therapy in 75 peptic ulcer disease patients.〈section xml:id="abs1-4"〉〈title type="main"〉Results:In 71 patients with complete follow-up, ulcers were healed at follow-up endoscopy and H. pylori was successfully eradicated. After 6 months, 93% (66 out of 71) of chronic acid-suppressant drug users had stopped acid-suppressant drug intake. The mean daily acid-suppressant drug dosage per patient decreased from 1.72 at entry to 0.03 units acid-suppressant drug (98%; P 〈 0.0001) during follow-up. The mean number of antacid tablets/day/patient was 0.26 during follow-up for the relief of mild inter-current dyspeptic symptoms. Medication use was not different in peptic ulcer disease patients with or without gastro-oesophageal reflux disease at baseline. The prevalence of gastro-oesophageal reflux disease decreased from 42% before to 35% after H. pylori eradication (N.S.).〈section xml:id="abs1-5"〉〈title type="main"〉Conclusion:Successful H. pylori eradication in peptic ulcer disease patients almost completely eliminates the need for acid-suppressant drug regardless of the presence or absence of gastro-oesophageal reflux disease at entry.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2001.01017.x
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