Optimal PPI-based triple therapy for the cure of Helicobacter pylori infection

A single center comparison of four 14-day schedules

Guiseppe Battaglia, Francesco Di Mario, Gioacchino Leandro, Maria Eugenia Benvenuti, Pietro Maria Donisi, Fabio Vianello, Nadia Dal Bò, Michele Pasini, Marcello Pasquino, Sergio Vigneri

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background. Helicobacter pylori eradication is accomplished using a wide array of drugs combined in a multitude of dosage schedules. The aim of the present study was to define the best 14-day eradication schedule using a PPI plus either two antibiotics or one antibiotic and bismuth. Material and Methods. For this study, 367 subjects (198 males, 169 females, age 22-87 years) with document H. pylori infection of the stomach were recruited from outpatients of the Gastroenterology Department of the Venezia Hospital. In all patients, H. pylori infection was identified by histology and the CLO-test. Patients were treated as follows: 1) PPI (P) plus clarithromycin (C) 250 mg plus amoxicillin (A) 1000mg bid (P+C+A); 2) P plus C plus bismuth subcitrate (B) 120 mg qid (P+C+B); 3) P plus C plus tinidazole (T) 500 mg bid (P+C+T); and 4) P plus A plus T bid (P+A+T). After two months, an upper gastrointestinal endoscopy was repeated for end point histological evaluation and the CLO- test. Positivity of one of the two methods was considered sufficient to define H. pylori as "not eradicated". Statistics: Chi-squared test and Fisher exact test. Results. Thirty-three subjects dropped out (six due to adverse events). P+C+B was proven significantly less effective than P+C+A, P+C+T and P+A+T, eradication rates being, respectively, 75.0%, 90.5%, 87.6%, 92.0%, (p = .005, per protocol analysis). Conclusions. All PPI-based triple therapies tested in this study were effective in curing H. pylori infection; however, P+C+B resulted in rates too low (<85%) to be recommended. P+C+A and P+A+T resulted in the high cure rates and thus may be considered the treatment of choice.

Original languageEnglish
Pages (from-to)115-119
Number of pages5
JournalHelicobacter
Volume3
Issue number2
Publication statusPublished - 1998

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Helicobacter Infections
Helicobacter pylori
Appointments and Schedules
Tinidazole
Anti-Bacterial Agents
Therapeutics
Bismuth
Gastrointestinal Endoscopy
Clarithromycin
Hospital Departments
Amoxicillin
Gastroenterology
Stomach
Histology
Outpatients
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Microbiology
  • Gastroenterology

Cite this

Battaglia, G., Di Mario, F., Leandro, G., Benvenuti, M. E., Donisi, P. M., Vianello, F., ... Vigneri, S. (1998). Optimal PPI-based triple therapy for the cure of Helicobacter pylori infection: A single center comparison of four 14-day schedules. Helicobacter, 3(2), 115-119.

Optimal PPI-based triple therapy for the cure of Helicobacter pylori infection : A single center comparison of four 14-day schedules. / Battaglia, Guiseppe; Di Mario, Francesco; Leandro, Gioacchino; Benvenuti, Maria Eugenia; Donisi, Pietro Maria; Vianello, Fabio; Dal Bò, Nadia; Pasini, Michele; Pasquino, Marcello; Vigneri, Sergio.

In: Helicobacter, Vol. 3, No. 2, 1998, p. 115-119.

Research output: Contribution to journalArticle

Battaglia, G, Di Mario, F, Leandro, G, Benvenuti, ME, Donisi, PM, Vianello, F, Dal Bò, N, Pasini, M, Pasquino, M & Vigneri, S 1998, 'Optimal PPI-based triple therapy for the cure of Helicobacter pylori infection: A single center comparison of four 14-day schedules', Helicobacter, vol. 3, no. 2, pp. 115-119.
Battaglia, Guiseppe ; Di Mario, Francesco ; Leandro, Gioacchino ; Benvenuti, Maria Eugenia ; Donisi, Pietro Maria ; Vianello, Fabio ; Dal Bò, Nadia ; Pasini, Michele ; Pasquino, Marcello ; Vigneri, Sergio. / Optimal PPI-based triple therapy for the cure of Helicobacter pylori infection : A single center comparison of four 14-day schedules. In: Helicobacter. 1998 ; Vol. 3, No. 2. pp. 115-119.
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abstract = "Background. Helicobacter pylori eradication is accomplished using a wide array of drugs combined in a multitude of dosage schedules. The aim of the present study was to define the best 14-day eradication schedule using a PPI plus either two antibiotics or one antibiotic and bismuth. Material and Methods. For this study, 367 subjects (198 males, 169 females, age 22-87 years) with document H. pylori infection of the stomach were recruited from outpatients of the Gastroenterology Department of the Venezia Hospital. In all patients, H. pylori infection was identified by histology and the CLO-test. Patients were treated as follows: 1) PPI (P) plus clarithromycin (C) 250 mg plus amoxicillin (A) 1000mg bid (P+C+A); 2) P plus C plus bismuth subcitrate (B) 120 mg qid (P+C+B); 3) P plus C plus tinidazole (T) 500 mg bid (P+C+T); and 4) P plus A plus T bid (P+A+T). After two months, an upper gastrointestinal endoscopy was repeated for end point histological evaluation and the CLO- test. Positivity of one of the two methods was considered sufficient to define H. pylori as {"}not eradicated{"}. Statistics: Chi-squared test and Fisher exact test. Results. Thirty-three subjects dropped out (six due to adverse events). P+C+B was proven significantly less effective than P+C+A, P+C+T and P+A+T, eradication rates being, respectively, 75.0{\%}, 90.5{\%}, 87.6{\%}, 92.0{\%}, (p = .005, per protocol analysis). Conclusions. All PPI-based triple therapies tested in this study were effective in curing H. pylori infection; however, P+C+B resulted in rates too low (<85{\%}) to be recommended. P+C+A and P+A+T resulted in the high cure rates and thus may be considered the treatment of choice.",
author = "Guiseppe Battaglia and {Di Mario}, Francesco and Gioacchino Leandro and Benvenuti, {Maria Eugenia} and Donisi, {Pietro Maria} and Fabio Vianello and {Dal B{\`o}}, Nadia and Michele Pasini and Marcello Pasquino and Sergio Vigneri",
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AU - Di Mario, Francesco

AU - Leandro, Gioacchino

AU - Benvenuti, Maria Eugenia

AU - Donisi, Pietro Maria

AU - Vianello, Fabio

AU - Dal Bò, Nadia

AU - Pasini, Michele

AU - Pasquino, Marcello

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N2 - Background. Helicobacter pylori eradication is accomplished using a wide array of drugs combined in a multitude of dosage schedules. The aim of the present study was to define the best 14-day eradication schedule using a PPI plus either two antibiotics or one antibiotic and bismuth. Material and Methods. For this study, 367 subjects (198 males, 169 females, age 22-87 years) with document H. pylori infection of the stomach were recruited from outpatients of the Gastroenterology Department of the Venezia Hospital. In all patients, H. pylori infection was identified by histology and the CLO-test. Patients were treated as follows: 1) PPI (P) plus clarithromycin (C) 250 mg plus amoxicillin (A) 1000mg bid (P+C+A); 2) P plus C plus bismuth subcitrate (B) 120 mg qid (P+C+B); 3) P plus C plus tinidazole (T) 500 mg bid (P+C+T); and 4) P plus A plus T bid (P+A+T). After two months, an upper gastrointestinal endoscopy was repeated for end point histological evaluation and the CLO- test. Positivity of one of the two methods was considered sufficient to define H. pylori as "not eradicated". Statistics: Chi-squared test and Fisher exact test. Results. Thirty-three subjects dropped out (six due to adverse events). P+C+B was proven significantly less effective than P+C+A, P+C+T and P+A+T, eradication rates being, respectively, 75.0%, 90.5%, 87.6%, 92.0%, (p = .005, per protocol analysis). Conclusions. All PPI-based triple therapies tested in this study were effective in curing H. pylori infection; however, P+C+B resulted in rates too low (<85%) to be recommended. P+C+A and P+A+T resulted in the high cure rates and thus may be considered the treatment of choice.

AB - Background. Helicobacter pylori eradication is accomplished using a wide array of drugs combined in a multitude of dosage schedules. The aim of the present study was to define the best 14-day eradication schedule using a PPI plus either two antibiotics or one antibiotic and bismuth. Material and Methods. For this study, 367 subjects (198 males, 169 females, age 22-87 years) with document H. pylori infection of the stomach were recruited from outpatients of the Gastroenterology Department of the Venezia Hospital. In all patients, H. pylori infection was identified by histology and the CLO-test. Patients were treated as follows: 1) PPI (P) plus clarithromycin (C) 250 mg plus amoxicillin (A) 1000mg bid (P+C+A); 2) P plus C plus bismuth subcitrate (B) 120 mg qid (P+C+B); 3) P plus C plus tinidazole (T) 500 mg bid (P+C+T); and 4) P plus A plus T bid (P+A+T). After two months, an upper gastrointestinal endoscopy was repeated for end point histological evaluation and the CLO- test. Positivity of one of the two methods was considered sufficient to define H. pylori as "not eradicated". Statistics: Chi-squared test and Fisher exact test. Results. Thirty-three subjects dropped out (six due to adverse events). P+C+B was proven significantly less effective than P+C+A, P+C+T and P+A+T, eradication rates being, respectively, 75.0%, 90.5%, 87.6%, 92.0%, (p = .005, per protocol analysis). Conclusions. All PPI-based triple therapies tested in this study were effective in curing H. pylori infection; however, P+C+B resulted in rates too low (<85%) to be recommended. P+C+A and P+A+T resulted in the high cure rates and thus may be considered the treatment of choice.

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