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Comparison of the efficacy of
1-day high-dose quadruple therapy versus 7-day triple
therapy for treatment of Helicobacter pylori infection
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BACKGROUND:
The proton pump inhibitor (PPI)-based 7-day triple therapy is the regimen
with the highest cure rates for eradication of Helicobacter pylori infection
and has been recommended as the first-line regimen in the world. It had been
reported that a 1-day quadruple therapy could also successfully cure 95% of
the H. pylori infected patients.
OBJECTIVES:
To observe the efficacy of 1-day high-dose quadruple therapy versus 7-day
triple therapy for treatment of H. pylori infection, and to observe
side-effects of the two different regimens.
METHODS:
This randomized, open, parallel-controlled study was conducted at Renji
Hospital between November 2004 to March 2005. A total of 80 consecutive
patients with non-ulcer dyspepsia, who were H. pylori positive proven by
both rapid urease test and histology were included and randomly assigned to
1-day quadruple therapy or 7-day triple therapy. Thirty-nine patients were
administered with 1-day high-dose quadruple therapy including esomeprazole
40 mg b.i.d., colloidal bismuth subcitrate 440 mg q.i.d., amoxicillin 2 g
q.i.d. and metronidazole (400 mg q.i.d.) for 1 day. Forty-one patients
received a standard 7-day triple therapy consisting of esomeprazole 20 mg
b.i.d., clarithromycin 500 mg b.i.d. and amoxicillin 1 g b.i.d. for 7 days.
The eradication rates were evaluated by the (13)C-urea breath test at least
4 weeks after completion of a course treatment.
RESULTS:
Seventy-seven patients completed the trial and three patients dropped out.
The eradication rates in the 1-day therapeutic group and the 7-day
therapeutic group were 39.5% (15/38) and 84.6% (33/39), respectively. There
was a statistically significant difference between the two groups (P <
0.0001). Short-lasting and self-limiting side effects including thirst, a
metallic taste, diarrhea and abdominal pain were reported in three patients
(7.9%) in the 1-day group and seven patients (18%) in the 7-day group (P =
0.31).
CONCLUSIONS:
A 1-day high-dose quadruple therapy with amoxicillin, metronidazole, bismuth
salt, and esomeprazole is
not effective for eradication of H. pylori compared with the
standard 7-day triple therapy.
Reference:
Chin J Dig Dis. 2005;6(4):202-5 |
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