Twelve-day quintuple regime containing four antibiotics as a rescue therapy for Helicobacter pylori eradication in the central region of Portugal
Rev. esp. enferm. dig
; 109(6): 430-434, jun. 2017. tab, ilus
Article
em En
| IBECS
| ID: ibc-163251
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
Background: Helicobacter pylori eradication rates with standard triple therapy in many countries are clinically unacceptable. Fluoroquinolone resistance is increasing and jeopardizing secondline regimens. There is a growing need for an effective strategy in patients who failed previous therapies. Methods: This is a single-center, non-randomized clinical study conducted in the central region of Portugal. Sixty-four patients were included with a positive 13C-urea breath test (UBT) or histology for H. pylori, and at least one failed eradication attempt. The patient cohort included 71.7% of females with a median of age of 52 (range 23-87). They were treated with a twelve-day regimen consisting of a proton-pump inhibitor (PPI) bid, amoxicillin at 1,000 mg 12/12h and levofloxacin at 500 mg bid during the first seven days, followed by PPI bid, clarithromycin at 500 mg 12/12 h and either tinidazole or metronidazole at 500 mg bid/tid for five days. Eradication was assessed by UBT. The local Ethics Committee approved this study. Results: Eradication therapy was prescribed due to dyspepsia (66.7%), peptic ulcer (10%) and thrombocytopenia (8.3%). The median number of failed therapies was one (range 1-4). The eradication rate was 64.6% according to an intention-to-treat analysis (95% CI: 53-77%), and 70% by the per-protocol analysis (95% CI: 58-82%). Age, smoking, indication for eradication, previous therapies and the use of a second-generation or full-dose PPI did not affect success rates. Conclusions: Even though treatment with four antibiotics was used, this «reinforced» therapy achieved suboptimal results. This fact highlights the lack of effective H. pylori antimicrobials and suggests that second-line treatment in our region should be prescribed according to susceptibility testing (AU)
RESUMEN
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Texto completo:
1
Coleções:
06-national
/
ES
Base de dados:
IBECS
Assunto principal:
Tinidazol
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Helicobacter pylori
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Levofloxacino
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Amoxicilina
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Metronidazol
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Guideline
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Risk_factors_studies
Aspecto:
Ethics
Limite:
Adult
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Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Rev. esp. enferm. dig
Ano de publicação:
2017
Tipo de documento:
Article