Comparison of 1-and 2-week pantoprazole-based triple therapies in clarithromycin-sensitive and resistant cases

被引:10
作者
Aydin, Ahmet
Onder, Goktug
Akarca, Ulus
Tekin, Fatih
Tuncyurek, Muge
Ilter, Tankut
机构
[1] Ege Univ, Sch Med, Dept Gastroenterol, Izmir, Turkey
[2] Ege Univ, Sch Med, Dept Pathol, Izmir, Turkey
关键词
pantoprazole; H; pylori; eradication; clarithromycin resistance;
D O I
10.1016/j.ejim.2007.02.018
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The objectives of this prospective study were: (i) to compare the efficacy of 1-week with 2-week pantoprazole-based triple therapy and (ii) to evaluate the impact of clarithromycin resistance on Helicobacter pylori (H. pylori) eradication rates. Methods: Eighty dyspeptic patients were randomly allocated to two groups. The first group (PAC-1, n = 40) received pantoprazole 40 mg, amoxicillin 1000 mg, and clarithromycin 500 mg twice a day for one week, and the second group (PAC-2, n = 40) received the same regimen for two weeks. Endoscopy was repeated one month after the end of the treatment. Results: DNA extraction for clarithromycin resistance could not be performed in seven cases. Five cases were lost to follow-up. Clarithromycin resistance was found to be 44.1% (15/34) in the PAC-1 group and 58.8% (20/34) in the PAC-2 group (p > 0.05). Eradication was achieved in 16 (PP: 47.1%, ITT: 44.4%) and 25 (PP:73.5%, ITT: 67.6%) patients in the PAC-1 and PAC-2 groups, respectively (p > 0.05). H. pylori was eradicated in 4 of 15 (PP: 26.7%, ITT: 26.7%) clarithromycin-resistant patients in the PAC-1 group and in 12 of 20 (PP: 60%, ITT: 60%) clarithromycin-resistant patients in the PAC-2 group (p > 0.05). Among the clarithromycin-sensitive ones, eradication was achieved in 12 of 19 (PP: 63.2%, ITT: 57.1%) patients in the PAC-1 group and in 13 of 14 (PP: 92.8%, ITT: 76.5%) patients in the PAC-2 group (p > 0.05). Conclusion: Although the 2-week regimen of pantoprazole-based triple therapy was effective for H. pylori eradication in clarithromycin-sensitive cases, highly effective H pylori eradication protocols are needed for clarithromycin-resistant ones. (C) 2007 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:496 / 500
页数:5
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