Factors affecting Helicobacter pylori eradication using a seven-day triple therapy with a proton pump inhibitor, tinidazole and clarithromycin, in Brazilian patients with peptic ulcer

• Published in: Revista do Hospital das Clinicás Vol. 56; no. 1; pp. 11 - 16
• Main Authors: Silva, F M, Zaterka, S, Eisig, J N, Chehter, E Z, Chinzon, D, Laudanna, A A
• Format: Journal Article
• Language: English
• Published: Brazil Faculdade de Medicina / Universidade de São Paulo - FM/USP 01-01-2001
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; Chi-Square Distribution; Clarithromycin - administration & dosage; Drug Administration Schedule; Drug Therapy, Combination; Enzyme Inhibitors - administration & dosage; Female; Helicobacter Infections - drug therapy; Helicobacter pylori; Humans; Lansoprazole; Logistic Models; Male; MEDICINE, GENERAL & INTERNAL; Middle Aged; Omeprazole - administration & dosage; Omeprazole - analogs & derivatives; Peptic Ulcer - drug therapy; Peptic Ulcer - microbiology; Proton Pump Inhibitors; Tinidazole - administration & dosage; Treatment Outcome; Peptic Ulcer Treatment; Clarithromycin; Tratamento da úlcera péptica; Tinidazol; Erradicação do Helicobacter pylori; Tinidazole; Inibidor de bomba de prótons; Claritromicina; Helicobacter pylori Eradication; Proton pump inhibitor
• ISSN: 0041-8781; 1678-9903; 0041-8781
• DOI: 10.1590/S0041-87812001000100003

Triple therapy is accepted as the treatment of choice for H. pylori eradication. In industrialized countries, a proton pump inhibitor plus clarithromycin and amoxicillin or nitroimidazole have shown the best results. Our aims were: 1. To study the eradication rate of the association of a proton pump inhibitor plus tinidazole and clarithromycin on H. pylori infection in our population. 2. To determine if previous treatments, gender, age, tobacco, alcohol use, and non-steroidal anti-inflammatory drugs (NSAIDs) change the response to therapy.
Two hundred patients with peptic ulcer (upper endoscopy) and H. pylori infection (histology and rapid urease test - RUT) were included. A proton pump inhibitor (lanzoprazole 30 mg or omeprazole 20 mg), tinidazole 500 mg, and clarithromycin 250 mg were dispensed twice a day for a seven-day period. Eradication was assessed after 10 to 12 weeks of treatment through histology and RUT.
The eradication rate of H. pylori per protocol was 65% (128/196 patients). This rate was 53% for previously treated patients, rising to 76% for not previously treated patients, with a statistical difference p<0.01. No significant difference was observed regarding sex, tobacco use, alcohol consumption, and NSAID use, but for elderly patients the difference was p = 0.05. Adherence to treatment was good, and side effects were mild.
A proton pump inhibitor, tinidazole, and clarithromycin bid for seven days resulted in H. pylori eradication in 65% of the patients. Previous treatments were the main cause of treatment failure.