Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients

Authors

  • Guilherme Felga School of Medicine, University of São Paulo, São Paulo, Brazil
  • Fernando Marcuz Silva School of Medicine, University of São Paulo, São Paulo, Brazil
  • Ricardo Correa Barbuti School of Medicine, University of São Paulo, São Paulo, Brazil
  • Tomas Navarro-Rodriguez School of Medicine, University of São Paulo, São Paulo, Brazil
  • Schlioma Zaterka School of Medicine, University of São Paulo, São Paulo, Brazil
  • Jaime Natan Eisig School of Medicine, University of São Paulo, São Paulo, Brazil

DOI:

https://doi.org/10.3855/jidc.911

Keywords:

Helicobacter pylori, peptic ulcer disease, treatment

Abstract

Introduction: The scheme proton pump inhibitor/amoxicillin/clarithromycin (PPI/AC) is still the first-line treatment for Helicobacter pylori (H. pylori) infections despite evidence suggesting its failure in up to 20% to 30% of patients.

Methodology: This study involved 493 patients who were prescribed omeprazole (20 mg twice a day) or another proton pump inhibitor in equivalent dosage, amoxicillin (1 g twice a day), and clarithromycin (500 mg twice a day) for seven days. Efficacy was determined by negative urease test and absence of H. pylori on gastric biopsy samples twelve weeks after the end of treatment. Safety was defined according to the adverse effects reported. Mean age of the patients was (± SD) 48.96 ± 13, and demographic and clinical data were recorded for correlation with treatment outcomes.

Results: Out of 493 patients, 316 (64.1%) presented duodenal ulcer, 111 (22.5%) gastric ulcer, and 66 (14.4%) simultaneous gastric and duodenal ulcers. Additionally, 267 (54.2%) patients had at least one risk factor for peptic ulcer disease, smoking being the most common (99 [36.5%]). Successful eradication was achieved in 408 patients. The eradication rates per protocol, and according to the intention to treat, were 88.8% and 82.7%, respectively.  Of 164 (35.5%) patients who presented adverse effects, 100 (61%) reported them as mild and only six (3.7%) patients had to discontinue treatment. Previous use of tobacco and non-steroid anti-inflammatory drugs was the only risk factor for treatment failure (P 0.00).

Conclusion: PPI/AC is still a valuable and remarkably tolerable option for first-line H. pylori eradication in Brazil.

Author Biographies

Guilherme Felga, School of Medicine, University of São Paulo, São Paulo, Brazil

Medical graduation at the Federal University of Juiz de Fora, Brazil. Medical residency in Internal Medicine at the University Hospital of the Federal University of Juiz de Fora. Medical residency in Gastroenterology and Hepatology at the University of São Paulo. Currently holds a position as assistant physician at the liver transplantation unit of the Hospital Israelita Albert Einstein, in São Paulo, Brazil. Great interest in gastroenterology and hepatology, with particular emphasis in pancreatic diseases.

Fernando Marcuz Silva, School of Medicine, University of São Paulo, São Paulo, Brazil

Gastroenterologist at the School of Medicine of the University of São Paulo. Assistant physician at the Internal Medicine department of the School of Medicine of the University of São Paulo. PhD in Medical Sciences by the University of São Paulo. Has a wide range of publications in peptic ulcer diseases, particularly in Helicobacter pylori treatment and Helicobacter pylori infection, pioneering this area in Brazil.

Ricardo Correa Barbuti, School of Medicine, University of São Paulo, São Paulo, Brazil

Gastroenterologist at the School of Medicine of the University of São Paulo. Assistant physician at the Gastroenterology department of the School of Medicine of the University of São Paulo. PhD in Medical Sciences by the University of São Paulo. Has a wide range of publications in peptic ulcer diseases, particularly in Helicobacter pylori treatment and Helicobacter pylori infection, pioneering this area in Brazil.

Tomas Navarro-Rodriguez, School of Medicine, University of São Paulo, São Paulo, Brazil

Gastroenterologist at the School of Medicine of the University of São Paulo. Assistant physician at the Gastroenterology department of the School of Medicine of the University of São Paulo. Chief of the Esophageal and Functional Disorders of the Upper GI Tract Clinic of the Gastroenterology department of the School of medicine of the University of São Paulo. PhD in Medical Sciences by the University of São Paulo, and post-doctoral at the Harvard University, US. Has a wide range of publications in peptic ulcer diseases, particularly in Helicobacter pylori treatment and Helicobacter pylori infection, pioneering this area in Brazil.

Schlioma Zaterka, School of Medicine, University of São Paulo, São Paulo, Brazil

Gastroenterologist at the School of Medicine of the University of São Paulo. Assistant physician at the Gastroenterology department of the School of Medicine of the University of São Paulo. PhD in Medical Sciences by the University of São Paulo. Has a wide range of publications in peptic ulcer diseases, particularly in Helicobacter pylori treatment and Helicobacter pylori infection, pioneering this area in Brazil.

Jaime Natan Eisig, School of Medicine, University of São Paulo, São Paulo, Brazil

Gastroenterologist at the School of Medicine of the University of São Paulo. Assistant physician at the Gastroenterology department of the School of Medicine of the University of São Paulo. Chief of the Peptic Ulcer Clinic of the Gastroenterology department of the School of medicine of the University of São Paulo. PhD in Medical Sciences by the University of São Paulo. Has a wide range of publications in peptic ulcer diseases, particularly in Helicobacter pylori treatment and Helicobacter pylori infection, pioneering this area in Brazil.

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Published

2010-07-21

How to Cite

1.
Felga G, Silva FM, Barbuti RC, Navarro-Rodriguez T, Zaterka S, Eisig JN (2010) Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients. J Infect Dev Ctries 4:712–716. doi: 10.3855/jidc.911

Issue

Vol. 4 No. 11: November 2010

Section

Original Articles

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