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

被引：57

作者：

Beales I.L.P. ^{[1
,2
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机构：

[1] Medical School, University of East Anglia

[2] Department of Gastroenterology, James Paget Hospital

来源：

BMC Gastroenterology | / 1卷 / 1期

关键词：

Metronidazole; Proton Pump Inhibitor; Pylorus Infection; Clarithromycin; Triple Therapy;

D O I：

10.1186/1471-230X-1-7

中图分类号：

学科分类号：

摘要：

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. © 2001 Beales; licensee BioMed Central Ltd.

引用

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