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Twelve-day quintuple regime containing four antibiotics as a rescue therapy for Helicobacter pylori eradication in the central region of Portugal
Branquinho, Diogo; Almeida, Nuno; Gregório, Carlos; Casela, Adriano; Manuel-Donato, Maria; Tomé, Luís.
Afiliação
  • Branquinho, Diogo; Centro Hospitalar e Universitário de Coimbra. Gastroenterology Department. Coimbra. Portugal
  • Almeida, Nuno; Centro Hospitalar e Universitário de Coimbra. Gastroenterology Department. Coimbra. Portugal
  • Gregório, Carlos; Centro Hospitalar e Universitário de Coimbra. Gastroenterology Department. Coimbra. Portugal
  • Casela, Adriano; Centro Hospitalar e Universitário de Coimbra. Gastroenterology Department. Coimbra. Portugal
  • Manuel-Donato, Maria; Universidade de Coimbra. Faculdade de Medicina. Gastroenterology Center. Coimbra. Portugal
  • Tomé, Luís; Centro Hospitalar e Universitário de Coimbra. Gastroenterology Department. Coimbra. 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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Assuntos

Texto completo: 1 Coleções: 06-national / ES Base de dados: IBECS Assunto principal: Tinidazol / Helicobacter pylori / Levofloxacino / Amoxicilina / Metronidazol Tipo de estudo: Clinical_trials / Etiology_studies / Guideline / Risk_factors_studies Aspecto: Ethics Limite: Adult / Aged / Female / Humans / Male Idioma: En Revista: Rev. esp. enferm. dig Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 06-national / ES Base de dados: IBECS Assunto principal: Tinidazol / Helicobacter pylori / Levofloxacino / Amoxicilina / Metronidazol Tipo de estudo: Clinical_trials / Etiology_studies / Guideline / Risk_factors_studies Aspecto: Ethics Limite: Adult / Aged / Female / Humans / Male Idioma: En Revista: Rev. esp. enferm. dig Ano de publicação: 2017 Tipo de documento: Article