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Helicobacter. 2011 Jun;16(3):229-33. doi: 10.1111/j.1523-5378.2011.00834.x.

High eradication rates of Helicobacter pylori infection following sequential therapy: the Israeli experience treating naïve patients.

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  • 1Gastroenterology Unit, Rabin Medical Center, Hasharon Hospital, Tel-Aviv University, Tel-Aviv, Israel.

Erratum in

  • Helicobacter. 2011 Aug;16(4):341. Schmiloviz-Weiss, Hemda [corrected to Schmilovitz-Weiss, Hemda].

Abstract

BACKGROUND:

Helicobacter pylori eradication rates following triple therapy are decreasing. Cure rates as low as 57%, mainly to claritromycin resistance, have been reported in Israel. Studies performed in Italy have shown eradication rates of 93%, following sequential therapy. Our aim was to evaluate the effect of sequential therapy on eradication rates of H. pylori in naïve Israeli patients.

MATERIAL AND METHODS:

Consecutive patients referred for esophagogastroduodenoscopy with a positive rapid urease test and positive (13) C urea breath test were included. Patients received omeprazole 20 mg bid and amoxicillin 1 g bid for 5 days followed by omeprazole 20 mg bid, clarithromycin 500 mg bid and tinidazole 500 mg bid for the subsequent 5 days. A second (13) C urea breath test was performed at least 4 weeks after completion of therapy. Patients were asked to avoid antibiotics, bismuth compounds or proton pump inhibitor until after the second (13) C urea breath test. Adverse effects were documented by a questionnaire.

RESULTS:

One hundred and twenty-four patients (mean age 56.1 ± 12.5 years, 55.6% women) were included; 120/124 (96.8%) completed treatment and performed the second (13) C urea breath test. Two patients (1.6%) were lost to follow-up; 2 (1.6%) were noncompliant with study regulations. One hundred and fifteen patients achieved eradication of H. pylori. The eradication rate was 95.8% by per protocol analysis and 92.7% by intention to treat analysis.

CONCLUSION:

The sequential regimen attained significantly higher eradication rates in naïve patients than usually reported for conventional triple therapy. Sequential therapy may be an alternative first-line therapy in eradicating H. pylori in Israel.

© 2011 Blackwell Publishing Ltd.

PMID:
21585609
[PubMed - indexed for MEDLINE]
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