STRATEGY FOR THE RETREATMENT OF FAILED HELICOBACTER-PYLORI ERADICATION THERAPY - A CASE SERIES

Citation
G. Battaglia et al., STRATEGY FOR THE RETREATMENT OF FAILED HELICOBACTER-PYLORI ERADICATION THERAPY - A CASE SERIES, Italian Journal of Gastroenterology and Hepatology, 30(4), 1998, pp. 370-374
Citations number
12
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenterology & Hepatology
ISSN journal
1125-8055
Volume
30
Issue
4
Year of publication
1998
Pages
370 - 374
Database
ISI
SICI code
1125-8055(1998)30:4<370:SFTROF>2.0.ZU;2-K
Abstract
Background. Helicobacter pylori eradication therapy can be unsuccessfu l in 5 to 20% of patients. Aim. To investigate the validity of a strat egy using triple therapies for the retreatment of patients with eradic ation failure, avoiding retreatment with antibiotics prone to induce r esistance after use in the first treatment. Patients and Methods. From a consecutive sampling of 108 patients still Helicobacter pylori-posi tive after a first course of antibiotic-based treatment 74 (68.5%) agr eed to a second course of triple therapy. Group I (N = 17): treatment failures on an imidazole (I)-based therapy were retreated with clarith romycin (C)-based regimen; Group 2 (N = 28): failures on a C-based the rapy with an I-based regimen; Group 3 (N = 7): failures on an IC-based therapy using an I-based regimen and Group 4 (N = 22): failures on a non-I/non-C based therapy with either an I-based, C-based or IC-based regimen. The presence of Helicobacter pylori was assessed by histology and the CLO-test at study entry and two months after stopping therapy Results. Nine patients were withdrawn from the study (12.2%) due to a lack of end point endoscopy. Helicobacter pylori tvas cured after the second course of therapy in all but seven patients [10.7% failure by Per Protocol analysis, 21.6% by Intention-To-Treat analysis]. No stati stically significant differences were found between the four groups (G roup 1: 92.9% PP, 76.5% ITT; Group 2: 90.9% PT: 71.4% ITT; Group 3: PP and ITT 85.7%; Group 4: PP and ITT 86.4%). Minor adverse events were experienced in nine, none of whom required withdrawal from the drug th erapy Conclusions. A second course of triple therapy with alternate an tibiotics effectively eradicated Helicobacter pylori, with only very f ew treatment failures. This suggests that the therapeutic strategy emp loyed may be recommended.