Eradication of Helicobacter pylori by triple therapy (amoxicillin, clarithromycin, omeprazole), in patients of the Hospital Dr. Rafael A. Calderón Guardia
DOI:
https://doi.org/10.51481/amc.v45i2.98Keywords:
Helicobacter py l o ri, t riple terap i a , resistencia a antibióticos, a m ox i c i l i n a , cl a ri t ro m i c i n a , omeprazoleAbstract
Justification and objective:H. pylorihas been associatedwith development of various types of gastric pathology inclu-ding chronic gastritis,peptic disease,intestinal-type adeno-carcinoma and lymphoma. Eradication of this infection is animportant recourse in the treament of patients with those pat-hologies. In this study,the triple therapy for the eradication ofH. pyloriinfection was evaluated in a group of chronic gas-tritis and peptic disease patients.
Methods:267 patients attending the Gastroenterology Clinicof HCG from January to May 2000 were included in thisstudy. H. pylori infection was determined by rapid ureasetest,culture and specific fecal antigen test. MIC was assessedby E-test for some isolates. The triple therapy was amoxici-llin (1000 mg),clarithromycin (500 mg - Claritrobac‚) andomeprazole (20 mg - Proton‚) given twicely for 10 days. Era-dication was defined as the conversion of a positive specificfecal antigen test at entry to negative test 30-45 days aftercessation of therapy.
Results:189 out of 267 patients (70,8%) completed the treat-ment. The eradication of H. pylori infection was achieved in84,7% patients,including 37 out of 39 (94,9%) patients suf-fering of peptic ulcer disease. Eradication was successfuleven in patients carrying H. pyloristrains which showed re-sistance either to amoxicillin or clarithromycin,although thepresence of sensible strains do not predict the success of thetherapy.
Conclusion:Triple therapy with amoxicillin (1000 mg),cla-rithromycin [Claritrobac‚] (500 mg) and omeprazole [Pro-ton‚] (20 mg) given twicely for 10 days eradicated theH. pyloriinfection in 84,7% of treated patients,including 37out of 39 patients suffering peptic ulcer disease. Triple the-rapy for 10 days is a successful option for the erradication ofH. Pylori infection
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References
Warren JR,Marshall B. Unidentified curved bacilli on gastric epithe-lium in active chronic gastritis. Lancet 1983 i:1273-1275.
Blaser MJ. Helicobacter pylori:microbiology of a ‘slow'bacterial in-fection. Trends Microbiol 1993; 1:255-260.
Blaser MJ. Helicobacter pylori and gastric diseases. Brit Med J 1998;316:1507-1510.
Bayerdörfer E,Neubauer A,Rudolph B, Thiede C,Lehn N,Eidt S et al.Regression of primary gastric lymphoma of mucosa-associated lymp-hoid tissue type after cure of Helicobacter pylori infection. Lancet1995; 345:1591-1594.
NomuraA,Stemmermann GN. Helicobacter pylori and gastric cancer.J Gastroenterol Hepatol 1993; 8:294-303.
Sipponen P. Gastric cancer:a long term consequence of Helicobacterpylori infection? Scand J Gastroenterol 1994; 29:24-27.
Axon ATR. The role of acid inhibition in the treatment of Helicobacterpylori infection. Scand J Gastroenterol 1994; 29(Suppl. 201):16-23.
Chiba N,Rao BV,Rademaker JW,Hunt RH. Meta-analysis of the effi-cacy of antibiotic therapy in erradicating Helicobacter pylori. Am JGastroenterol 1992; 87:1716-1727.
de Boer WA,Tytgat GNJ. Treatment of Helicobacter pylori infection.Br Med J 2000; 320:31-34.
Harris A,Misiewicz JJ. Management of Helicobacter pylori infection.Brit Med J 2001; 323:1047-1049.
van der Hulst RWM,Keller JJ,Rauws EAJ, Tygat GNJ. Treatment ofHelicobacter pylori infection:a review of the wold literature. Helico-bacter 1996; 1:6-19.
de Boer WA,Tytgat GNJ. Ninety percent cure:which anti-Helicobactertherapy can achieve this treatment goal? Am J Gastroenterol 1995; 90:1381-1382.
European Helicobacter pylori Study Group. Current European conceptsin the management of Helicobacter pylori infection. The MaastrichtConsensus Report. Eur J Gastroenterol Hepatol 1997; 9:1-2.
Lind T, Van Zanten SV,Unge P.,Spiller R,Bayerdorffer E,O'MorainC et al. Eradication of Helicobacter pylori using one week triple thera-pies combining omeprazole with two antimicrobials:The MACH 1study. Helicobacter 1996; 1:138-144.
Lind T,Mégraud F,Unge P,Bayerdörfer E,O Morain C,Spiller R et al.The MACH 2 study:role of omeprazole in eradication of Helicobacterpylori with 1-week triple therapies. Gastroenterology 1999; 116:248-253.
Malfertheiner P,Mégraud F,O'Morain C,Bell D,Bianch G,DeltenreM et al. Current European concepts in the management of Helicobacterpylori infection - the Maastricht consensus report. Gut 1997; 41:8-13.
Gonzaga Vaz Coelho L,León-Barúa R,Quigley EMM and representa-tives of the Latin-American National Gastroenterological Societies af-filiated with the Inter-American Association of Gastroenterology (AI-GE). Latin-American Consensus Conference on Helicobacter pylori in-fection. Am J Gastroenterol 2000; 95:2688-2691.
de Boer WA.,Tytgat GNJ. How to treat Helicobacter pylori infection -should treatment strategies be based on testing bacterial susceptibility?A personal point of view. Eur J Gastroenterol Hepatol 1996; 8:709-716.
Lang L. Determinación de los patrones de susceptibilidad a antimicro-bianos en cepas de Helicobacter pylori aisladas en Costa Rica. Tesis deMaestría. Sistema de Estudios de Posgrado,Universidad de Costa Ri-ca. 2002.
Roth DE,Taylor DN,Gilman RH,Meza R,Katz U,Bautista C et al.Posttreatment follow-up of Helicobacter pylori infection using a stoolantigen immunoassay. Clin Diagn Lab Immunol 2001; 8:718-723.
Taylor N, Fox JG,Akopyants NS,Berg DE,Thompson N,Shames Bet al. Long-term colonization with single and multiple strains of Heli-cobacter pylori assessed by DNA fingerprinting. J Clin Microbiol1995; 33:918-923.
Adamek RJ,Suerbaum S,Pfaffenbach B,Opferkuch W. Primary andacquired Helicobacter pylori resistance to clarithromycin,metronida-zole and amoxicillin:influence on treatment outcome.Am J Gastroen-terol 1998; 93:386-389.
Dore MP,Piana A,Carta M,Atzei A,Are BM,Mura I et al. Amoxici-llin resistance is one reason for failure of amoxicillin-omeprazole treat-ment of Helicobacter pylori infection. Aliment Pharmacol Ther 1998;12:635-639.
Glupczynski Y,Burette A. Drug therapy of Helicobacter pylori infec-tion:problems and pitfalls. Am J Gastroenterol 1989; 85:1545-1551.
Graham DY.Antibiotic resistance in Helicobacter pylori:implicationsfor therapy. Gastroenterology 1998; 115:1272-1277.
Han SR,Bhakdi S,Maeurer MJ,Schneider T,Gehring S. Stable andunstable amoxicillin resistance in Helicobacter pylori:should antibio-tic resistance testing be performed prior to erradication therapy? J ClinMicrobiol 1999; 37:2740-2741.
Matsuoka M,Yoshida Y,Hayakawa K,Fukuchi S,Sugona K. Simulta-neous colonisation of Helicobacter pylori with and without mutationsin the 23S rRNA gene in patients with no history of clarithromycin ex-posure. Gut 1999; 45:503-507.
Mégraud F. Epidemiology and mechanism of antibiotic resistance inHelicobacter pylori. Gastroenterology 1998; 115:1278-1282.
Mégraud F,Lehn N,Lind T,Bayerdörffer E,O'Morain C,Spiller R etal. Antimicrobial susceptibility testing of Helicobacter pylori in a largemulticenter trial:the MACH 2 study.Antimicrob Agents Chemother1999; 43:2747-2752.
Realdi G,Dore MP,Piana A,Atzei A,Carta M,Cugia L et al. Pretreat-ment antibiotic resistance in Helicobacter pylori infection:results ofthree randomized controlled trials. Helicobacter 1999; 4:106-112.
Chanto-Chacón G.Análisis molecular de cepas de Helicobacter pyloriaisladas de pacientes con patología gástrica mediante la técnica deADN polimórfico amplificado al azar (random amplified polymorphicDNA,RAPD). Trabajo Final de Graduación. Facultad de Microbiolo-gía,Universidad de Costa Rica. 1999.
Pachón SE. Tratamiento de la infección por Helicobacter pylori en ungrupo de pacientes con enfermedad úlcero-péptica en Costa Rica. Te-sis de Especialidad. Sistema de Estudios de Posgrado,Universidad deCosta Rica. 1999.
Toruño Z. Comparación de esquemas cortos de tratamiento para laerradicación de Helicobacter pylori en pacientes con gastritis. HospitalSan Juan de Dios 1998-1999. Tesis de Especialidad. Sistema de Estu-dios de Posgrado,Universidad de Costa Rica.1999.
Sierra R,Salas P,Mora-Zúñiga F,Sanabria M,ChinnockA,Peña S,etal. Erradicación de Helicobacter pylori en una población de alto riesgode cáncer gástrico. Acta Méd Costarric 1998; 40:30-35.
Sierra R,Muñoz N,Sanabria M,Mora-Zúñiga F,Quirós E,Brenes F,et al. Helicobacter pylori ¿Es posible la erradicación? Rev. Costarric.Salud Pública 1999; 14:37-43
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