Bismuth, lansoprazole, amoxicillin and metronidazole or clarithromycin as first-line Helicobacter pylori therapy

Gut
Wei ZhangHong Lu

Abstract

To evaluate the efficacy and tolerability of replacing tetracycline with amoxicillin in bismuth quadruple therapy. Subjects who were infected with Helicobacter pylori and naïve to treatment were randomly (1:1) assigned to receive a 14-day modified bismuth quadruple therapy: lansoprazole 30 mg, amoxicillin 1 g, bismuth potassium citrate 220 mg (elemental bismuth), twice a day with metronidazole 400 mg four times a day (metronidazole group) or clarithromycin 500 mg twice a day (clarithromycin group). Six weeks after treatment, H. pylori eradication was assessed by 13C-urea breath test. Antimicrobial susceptibility was assessed by the twofold agar dilution method. This was a non-inferiority trial. Two hundred and fifteen subjects were randomised. Metronidazole and clarithromycin containing regimens achieved high cure rates: 94 of 97 (96.9%, 95% CI 93.5% to 100%) and 93 of 98 (94.9%, 95% CI 90.5% to 99.3%) by per-protocol and 88.9% (95% CI 83.0% to 94.8%) and 88.8% (95% CI 82.8% to 94.8%) by intention-to-treat, respectively. Amoxicillin, metronidazole and clarithromycin resistance rates were 1.5%, 45.5% and 26.5%, respectively. Only clarithromycin resistance reduced treatment success (e.g., susceptible 98.6%, resistant 76.9%, p=0.0...Continue Reading

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Citations

Feb 7, 2016·Clinics and Research in Hepatology and Gastroenterology·Nelly MullerJean-Charles Delchier
Apr 15, 2016·Expert Review of Anti-infective Therapy·David Y Graham, Maria Pina Dore
May 15, 2016·Current Gastroenterology Reports·Elizabeth A MarcusDavid R Scott
May 25, 2016·Gastroenterology·David Y Graham, Loren Laine
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Aug 18, 2016·Helicobacter·Anthony O'ConnorColm O'Morain
May 10, 2016·The Journal of Comparative Neurology·Meng-Lin LiaoChung-Liang Chien
Oct 23, 2016·Lancet·Jyh-Ming LiouUNKNOWN Taiwan Gastrointestinal Disease and Helicobacter Consortium
Apr 19, 2016·Journal of Gastroenterology and Hepatology·Jyh-Ming LiouJaw-Town Lin
Jan 13, 2017·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·L WangJ Si
Mar 8, 2018·Helicobacter·Wen Zhong LiuUNKNOWN Chinese Society of Gastroenterology, Chinese Study Group on Helicobacter pylori and Peptic Ulcer
Mar 7, 2018·Toxicology and Industrial Health·Yongming LiuLeshuai W Zhang
Sep 30, 2017·The Journal of Antimicrobial Chemotherapy·Mei-Jyh ChenUNKNOWN Taiwan Gastrointestinal Disease and Helicobacter Consortium
Jun 13, 2019·Journal of Cellular Physiology·Masoud KeikhaMohsen Karbalaei
Jan 14, 2020·Journal of Gastroenterology and Hepatology·Guofeng YinMizu Jiang
Jun 4, 2017·Digestive Diseases and Sciences·Marjan MohammadiDavid Y Graham
Jan 16, 2019·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Jae Yong Park, Jae Gyu Kim
Jan 10, 2020·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Yong-Sheng TengYuan Zhuang
Mar 21, 2017·Digestive Diseases and Sciences·Yi HuNong-Hua Lu
May 4, 2017·Helicobacter·Javier P Gisbert, Adrian G McNicholl
Apr 19, 2018·Arquivos De Gastroenterologia·Luiz Gonzaga Vaz CoelhoJoaquim Prado de Moraes-Filho

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