Triple therapy for Helicobacter pylori eradication: a comparison of pantoprazole once versus twice daily

Citation
Kd. Bardhan et al., Triple therapy for Helicobacter pylori eradication: a comparison of pantoprazole once versus twice daily, ALIM PHARM, 14(1), 2000, pp. 59-67
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pharmacology,"da verificare
Journal title
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ISSN journal
0269-2813 → ACNP
Volume
14
Issue
1
Year of publication
2000
Pages
59 - 67
Database
ISI
SICI code
0269-2813(200001)14:1<59:TTFHPE>2.0.ZU;2-Z
Abstract
Background:Proton pump inhibitor-based triple therapy is recommended as tre atment for Helicobacter pylori eradication. The proton pump inhibitor may b e given once or twice daily. However, little information is available on ho w these two treatment strategies compare. Methods: H. pylori-positive patients (two positive test results) with endos copy-proven healed duodenal ulcer or non-ulcer dyspesia were randomly alloc ated to 1 week of double-blind treatment with pantoprazole 40 mg once or tw ice daily, plus clarithromycin 250 mg and metronidazole 400 mg twice daily. Eradication was defined as a negative C-13-urea breath test (C-13-UBT) and histology, 4-5 weeks post-treatment. The follow-up phase comprised 12 mont hs off therapy, with C-13-UBT at 6 and 12 months. Results: Two hundred and four patients received treatment: pantoprazole onc e daily (x1), n=104; twice daily (x2), n=100. Eradication rates were 84% in both the pantoprazole x1 and pantoprazole x2 groups by modified intention- to-treat analysis and 89% and 87%, respectively, by per protocol analysis. Metronidazole resistance was found in 44% of pre-treatment cultures of H. p ylori. Eradication rates were similar in susceptible (72%) and resistant (7 5%) strains. During follow-up, recrudescence of infection occurred in 3/118 patients. Conclusion: When using pantoprazole plus clarithromycin and metronidazole, the proton pump inhibitor can be used once daily without loss of efficacy.