Highly Effective Second-Line Anti-Helicobacter pylori Therapy in Patients with Previously Failed Metronidazole-Based Therapy

• Published in: Scandinavian journal of gastroenterology Vol. 32; no. 12; pp. 1209 - 1214
• Main Authors: Lerang, F., Moum, B., Haug, J. B., Berge, T., Tolas, P., Sandvei, P. K., Torp, R., Tønnesen, T.
• Format: Journal Article
• Language: English
• Published: Copenhagen Informa UK Ltd 1997; Oslo Taylor & Francis; Stockholm Scandinavian University Press
• Subjects: Adult; Aged; Amoxicillin - administration & dosage; Anti-Bacterial Agents - administration & dosage; Anti-Ulcer Agents - administration & dosage; Antimicrobial resistance; Antitrichomonal Agents - therapeutic use; Biological and medical sciences; clarithromycin; Clarithromycin - administration & dosage; Digestive system; Drug Evaluation; Drug Therapy, Combination; Female; Helicobacter Infections - drug therapy; Helicobacter Infections - microbiology; Helicobacter pylori; Humans; Male; Medical sciences; metronidazole; Metronidazole - therapeutic use; Microbial Sensitivity Tests; Middle Aged; Omeprazole - administration & dosage; Organometallic Compounds - administration & dosage; Oxytetracycline - administration & dosage; Pharmacology. Drug treatments; Prospective Studies; second-line therapy; triple therapy; Human; Evaluation; Second order; Therapy; Clarithromycin; Spirillales; Triplet; Spirillaceae; Macrolide; Antimicrobial agent; Infection; Antibiotic; Gastroduodenal; Helicobacter pylori; Bacteriosis; Digestive diseases; Bacteria; Intestinal disease; Ulcer; Antibacterial agent; Negative therapeutic reaction; Comparative study; Gastric disease
• ISSN: 0036-5521; 1502-7708
• DOI: 10.3109/00365529709028149

Background: In this study we compared the cure rates of two clarithromycin-based regimens in patients in whom anti-Helicobacter pylori therapy had previously failed. Methods: Thirty-three patients were randomized to receive either regimen OAC (20 mg omeprazole, 750 mg amoxicillin, and 250 mg clarithromycin) or BTC (240 mg bismuth subcitrate, 750 mg oxytetracycline, and 250 mg clarithromycin), all twice daily for 10 days. A further 28 patients were all treated with OAC. Previously failed therapy included combinations of bismuth (B), omeprazole (O), tetracycline (T), metronidazole (M), amoxicillin (A), or clarithromycin (C) in BTM (n = 48), OAM (n = 13), OA (n = 7), OCM (n = 2), or BCM (n = 1). H. pylori infection was confirmed by culture of biopsy specimens, and antimicrobial susceptibility testing was performed with the E test. Results: H. pylori infection was cured in all patients (n = 18) with OAC and in 8 patients (53%) with BTC (P = 0.001) in the randomized group and in 27 patients (96%) receiving OAC in the open-label group. Conclusions: Ten-day OAC is highly effective and superior to BTC in patients in whom metronidazole-based treatment has previously failed.