RT Journal Article
T1 Fourteen-day high-dose esomeprazole, amoxicillin and metronidazole as third-line treatment for Helicobacter pylori infection
A1 Puig, Ignasi
A1 Gonzalez-Santiago, Jesus M.
A1 Molina-Infante, Javier
A1 Barrio, Jesus
A1 Teresa Herranz, Maria
A1 Algaba, Alicia
A1 Castro, Manuel
A1 Gisbert, Javier P.
A1 Calvet, Xavier
K1 amoxicillin
K1 esomeprazole
K1 Helicobacter pylori
K1 metronidazole
K1 rescue treatment
K1 third-line treatment
K1 Triple therapy
K1 Rescue therapy
K1 Quadruple therapy
K1 Pump inhibitors
K1 Levofloxacin
K1 Eradication
K1 Efficacy
K1 Metaanalysis
K1 Rifabutin
K1 Bismuth
AB IntroductionThe efficacy of currently recommended third-line therapies for Helicobacter pylori is suboptimal, even that of culture-guided treatments. Resistance to multiple antibiotics is the major factor related to treatment failure. The aim of this study was to evaluate the effectiveness and safety of a 14-day therapy using high-dose of amoxicillin, metronidazole and esomeprazole.Material and methodsMulticenter open-label study as a register in routine clinical practice in patients with two previous failures of eradication therapy. A triple therapy with esomeprazole 40mg b.d., amoxicillin 1g t.d.s and metronidazole 500mg t.d.s for 2weeks was administered as a third-line therapy after a first treatment including clarithromycin and a second treatment including a quinolone. Helicobacter pylori status was determined by either histology or C-13-UBT both before and after treatment.ResultsA total of 68 patients were included in this study. An interim analysis showed that only three out of eight patients who had received metronidazole in previous eradication regimens were cured (37%, 95% CI 8-75); as a result, after this interim analysis only metronidazole-naive patients were included. The ITT eradication rate in metronidazole-naive patients was 64% (95% CI 51-76). Adverse events occurred in 58% of patients, all of them mild-to-moderate. Two patients (3%) did not complete >90% of the treatment because of side effects. No severe adverse events occurred.ConclusionCure rates of this 14-day schedule using high-dose esomeprazole, amoxicillin and metronidazole as a third-line eradication regimen were suboptimal, especially in patients who had received metronidazole in previous failed eradication regimens.
PB Wiley
SN 1368-5031
YR 2017
FD 2017-09-01
LK http://hdl.handle.net/10668/18989
UL http://hdl.handle.net/10668/18989
LA en
DS RISalud
RD Apr 11, 2025