Optimizing first line 7‐day standard triple therapy for Helicobacter pylori eradication: Prolonging treatment or adding bismuth: which is better?

Leow, Alex Hwong Ruey and Azmi, Ahmad Najib and Loke, Mun Fai and Vadivelu, Jamuna and Graham, David Yates and Goh, Khean Lee (2018) Optimizing first line 7‐day standard triple therapy for Helicobacter pylori eradication: Prolonging treatment or adding bismuth: which is better? Journal of Digestive Diseases, 19 (11). pp. 674-677. ISSN 1751-2972

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Official URL: https://doi.org/10.1111/1751-2980.12679

Abstract

Objective: The 7-day standard triple therapy (STT) gives unacceptablly low eradication rates of Helicobacter pylori (H. pylori). We aimed to examine whether extending STT from 7 days to 14 days or adding a bismuth compound to a 7-day STT would result in better eradication rates. Methods: H. pylori-positive patients were assigned to Group A (7-day STT; rabeprazole 20 mg twice daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily, for 7 days), Group B (7-day STT with bismuth; rabeprazole 20 mg twice daily, amoxicillin 1 g twice daily, clarithromycin 500 mg twice daily and bismuth subcitrate 240 mg twice daily, for 7 days) and Group C (14-day STT; rabeprazole 20 mg twice daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily for 14 days). Eradication was tested using 13 C-UBT at least 4 weeks after the completion of therapy. Results: A total of 364 patients were recruited. In the intention-to-treat analysis, eradication rates were 79.3% (96/121; 95% confidence interval [CI] 71.3–85.6%) for 7-day STT, 81.7% (98/120; 95% CI 73.8–87.6%) for 7-day STT with bismuth, and 88.6% (109/123; 95% CI 81.8–93.1%) for 14-day STT, respectively. Statistical significance was achieved between the 7-day and the 14-day STT treatment (P = 0.048). Conclusions: Adding bismuth to the 7-day STT did not result in an increase in the eradication rate. Extending the STT to 14 days, however, achieved a significantly higher eradication rate. Nevertheless, this did not achieve the targeted 90% eradication rate on intention-to-treat analysis.

Item Type: Article
Uncontrolled Keywords: bismuth; Helicobacter pylori eradication; proton pump inhibitors; standard triple therapy
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 17 Jun 2019 06:43
Last Modified: 17 Jun 2019 06:43
URI: http://eprints.um.edu.my/id/eprint/21481

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