Amoxicillin/tetracycline combinations are inadequate as alternative therapies for Helicobacter pylori infection

Francesco Perri, Virginia Festa, Antonio Merla, Michele Quitadamo, Rocco Clemente, Angelo Andriulli

Research output: Contribution to journalArticle

Abstract

Background. Triple therapy with proton pump inhibitors or ranitidine bismuth citrate, clarithromycin and either amoxicillin or nitroimidazole derivatives are the present gold standards for cure of Helicobacterpylori infection. However, primary resistance to either clarithromycin or nitroimidazole derivatives is increasing and alternative therapies are needed. Aim. To determine the efficacy and safety of three regimens consisting of amoxicillin and tetracycline or doxycycline combined with either lansoprazole or ranitidine bismuth citrate. Methods. Two hundred and seventy H. pylori infected patients were randomly given one of the following treatments: amoxicillin 1 g twice a day (b.i.d.) plus tetracycline 500 mg four times a day (q.i.d.) with either lansoprazole 30 mg b.i.d. (group LAT) or ranitidine bismuth citrate 400 mg b.i.d. (group RBCAT) for 7 days and amoxicillin 1 g b.i.d. plus doxycycline 100 mg b.i.d. and lansoprazole 30 mg b.i.d. for 14 days (group LAD). Eradication rate was assessed by UBT at 4-6 weeks after therapy. Results. The three groups (LAT, RBCAT, and LAD) of patients achieved eradication rates of 35% (25-45), 20% (12-29) and 36% (25-46), respectively, on intention-to-treat analysis. Patient compliance was optimal and side-effects minimal in all three groups. Conclusions. Although the amoxicillin/tetracycline combination is attractive (inexpensive, safe, and with low primary resistance rate), it can not be recommended for H. pylori eradication.

Original languageEnglish
Pages (from-to)99-104
Number of pages6
JournalHelicobacter
Volume7
Issue number2
DOIs
Publication statusPublished - 2002

Fingerprint

Amoxicillin
Helicobacter Infections
Complementary Therapies
Tetracycline
Helicobacter pylori
Lansoprazole
Nitroimidazoles
Clarithromycin
Doxycycline
Intention to Treat Analysis
Proton Pump Inhibitors
Patient Compliance
Therapeutics
Safety
Infection
ranitidine bismuth citrate

Keywords

  • Antibiotic
  • Eradication
  • Failure
  • Helicobacter pylori
  • Lansoprazole
  • Ranitidine bismuth citrate

ASJC Scopus subject areas

  • Gastroenterology
  • Microbiology

Cite this

Amoxicillin/tetracycline combinations are inadequate as alternative therapies for Helicobacter pylori infection. / Perri, Francesco; Festa, Virginia; Merla, Antonio; Quitadamo, Michele; Clemente, Rocco; Andriulli, Angelo.

In: Helicobacter, Vol. 7, No. 2, 2002, p. 99-104.

Research output: Contribution to journalArticle

Perri, Francesco ; Festa, Virginia ; Merla, Antonio ; Quitadamo, Michele ; Clemente, Rocco ; Andriulli, Angelo. / Amoxicillin/tetracycline combinations are inadequate as alternative therapies for Helicobacter pylori infection. In: Helicobacter. 2002 ; Vol. 7, No. 2. pp. 99-104.
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abstract = "Background. Triple therapy with proton pump inhibitors or ranitidine bismuth citrate, clarithromycin and either amoxicillin or nitroimidazole derivatives are the present gold standards for cure of Helicobacterpylori infection. However, primary resistance to either clarithromycin or nitroimidazole derivatives is increasing and alternative therapies are needed. Aim. To determine the efficacy and safety of three regimens consisting of amoxicillin and tetracycline or doxycycline combined with either lansoprazole or ranitidine bismuth citrate. Methods. Two hundred and seventy H. pylori infected patients were randomly given one of the following treatments: amoxicillin 1 g twice a day (b.i.d.) plus tetracycline 500 mg four times a day (q.i.d.) with either lansoprazole 30 mg b.i.d. (group LAT) or ranitidine bismuth citrate 400 mg b.i.d. (group RBCAT) for 7 days and amoxicillin 1 g b.i.d. plus doxycycline 100 mg b.i.d. and lansoprazole 30 mg b.i.d. for 14 days (group LAD). Eradication rate was assessed by UBT at 4-6 weeks after therapy. Results. The three groups (LAT, RBCAT, and LAD) of patients achieved eradication rates of 35{\%} (25-45), 20{\%} (12-29) and 36{\%} (25-46), respectively, on intention-to-treat analysis. Patient compliance was optimal and side-effects minimal in all three groups. Conclusions. Although the amoxicillin/tetracycline combination is attractive (inexpensive, safe, and with low primary resistance rate), it can not be recommended for H. pylori eradication.",
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T1 - Amoxicillin/tetracycline combinations are inadequate as alternative therapies for Helicobacter pylori infection

AU - Perri, Francesco

AU - Festa, Virginia

AU - Merla, Antonio

AU - Quitadamo, Michele

AU - Clemente, Rocco

AU - Andriulli, Angelo

PY - 2002

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N2 - Background. Triple therapy with proton pump inhibitors or ranitidine bismuth citrate, clarithromycin and either amoxicillin or nitroimidazole derivatives are the present gold standards for cure of Helicobacterpylori infection. However, primary resistance to either clarithromycin or nitroimidazole derivatives is increasing and alternative therapies are needed. Aim. To determine the efficacy and safety of three regimens consisting of amoxicillin and tetracycline or doxycycline combined with either lansoprazole or ranitidine bismuth citrate. Methods. Two hundred and seventy H. pylori infected patients were randomly given one of the following treatments: amoxicillin 1 g twice a day (b.i.d.) plus tetracycline 500 mg four times a day (q.i.d.) with either lansoprazole 30 mg b.i.d. (group LAT) or ranitidine bismuth citrate 400 mg b.i.d. (group RBCAT) for 7 days and amoxicillin 1 g b.i.d. plus doxycycline 100 mg b.i.d. and lansoprazole 30 mg b.i.d. for 14 days (group LAD). Eradication rate was assessed by UBT at 4-6 weeks after therapy. Results. The three groups (LAT, RBCAT, and LAD) of patients achieved eradication rates of 35% (25-45), 20% (12-29) and 36% (25-46), respectively, on intention-to-treat analysis. Patient compliance was optimal and side-effects minimal in all three groups. Conclusions. Although the amoxicillin/tetracycline combination is attractive (inexpensive, safe, and with low primary resistance rate), it can not be recommended for H. pylori eradication.

AB - Background. Triple therapy with proton pump inhibitors or ranitidine bismuth citrate, clarithromycin and either amoxicillin or nitroimidazole derivatives are the present gold standards for cure of Helicobacterpylori infection. However, primary resistance to either clarithromycin or nitroimidazole derivatives is increasing and alternative therapies are needed. Aim. To determine the efficacy and safety of three regimens consisting of amoxicillin and tetracycline or doxycycline combined with either lansoprazole or ranitidine bismuth citrate. Methods. Two hundred and seventy H. pylori infected patients were randomly given one of the following treatments: amoxicillin 1 g twice a day (b.i.d.) plus tetracycline 500 mg four times a day (q.i.d.) with either lansoprazole 30 mg b.i.d. (group LAT) or ranitidine bismuth citrate 400 mg b.i.d. (group RBCAT) for 7 days and amoxicillin 1 g b.i.d. plus doxycycline 100 mg b.i.d. and lansoprazole 30 mg b.i.d. for 14 days (group LAD). Eradication rate was assessed by UBT at 4-6 weeks after therapy. Results. The three groups (LAT, RBCAT, and LAD) of patients achieved eradication rates of 35% (25-45), 20% (12-29) and 36% (25-46), respectively, on intention-to-treat analysis. Patient compliance was optimal and side-effects minimal in all three groups. Conclusions. Although the amoxicillin/tetracycline combination is attractive (inexpensive, safe, and with low primary resistance rate), it can not be recommended for H. pylori eradication.

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KW - Eradication

KW - Failure

KW - Helicobacter pylori

KW - Lansoprazole

KW - Ranitidine bismuth citrate

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