Primary resistance to antibiotics and its clinical impact on the efficacy of Helicobacter pylori lansoprazole‐based triple therapies
SK Poon, CS Chang, J Su, CH Lai… - Alimentary …, 2002 - Wiley Online Library
Alimentary pharmacology & therapeutics, 2002•Wiley Online Library
Aim: To evaluate Helicobacter pylori primary resistance and its clinical impact on the efficacy
of two lansoprazole‐based eradication triple therapies. Methods: H. pylori‐positive patients
(n= 228) were randomized to receive one of the 1‐week regimens: lansoprazole 30 mg,
clarithromycin 500 mg and amoxicillin 1 g (LAC), or lansoprazole 30 mg, clarithromycin 500
mg and metronidazole 500 mg (LMC), each given twice daily. H. pylori status was assessed
by 13C‐urea breath test and culture at diagnosis and by 13C‐urea breath test 6 weeks after …
of two lansoprazole‐based eradication triple therapies. Methods: H. pylori‐positive patients
(n= 228) were randomized to receive one of the 1‐week regimens: lansoprazole 30 mg,
clarithromycin 500 mg and amoxicillin 1 g (LAC), or lansoprazole 30 mg, clarithromycin 500
mg and metronidazole 500 mg (LMC), each given twice daily. H. pylori status was assessed
by 13C‐urea breath test and culture at diagnosis and by 13C‐urea breath test 6 weeks after …
Aim
To evaluate Helicobacter pylori primary resistance and its clinical impact on the efficacy of two lansoprazole‐based eradication triple therapies.
Methods
H. pylori‐positive patients (n=228) were randomized to receive one of the 1‐week regimens: lansoprazole 30 mg, clarithromycin 500 mg and amoxicillin 1 g (LAC), or lansoprazole 30 mg, clarithromycin 500 mg and metronidazole 500 mg (LMC), each given twice daily. H. pylori status was assessed by 13C‐urea breath test and culture at diagnosis and by 13C‐urea breath test 6 weeks after therapy. Antibiotic susceptibility was determined by E‐test (n=98).
Results
The eradication rates with per protocol/ intention‐to‐treat analyses were: LAC (n=95/114) 83%/69% and LMC (n=96/114) 85%/72%. Primary resistance was 11% for clarithromycin, 41% for metronidazole and 0% for amoxicillin. Eradication in metronidazole‐susceptible/‐resistant strains was 85%/82% in LAC and 83%/63% in LMC. Significantly lower cure rates were observed in clarithromycin‐resistant patients treated with LAC (95% vs. 0%, P < 0.001) and LMC (86% vs. 0%, P < 0.001).
Conclusions
One‐week LAC and LMC are similarly effective therapies. Clarithromycin resistance significantly affected H. pylori eradication in both regimens.
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