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document
Amoxicillin/metronidazole/omeprazole/clarithromycin : a new , short quadruple therapy for Helicobacter pylori eradication . BACKGROUND Triple therapy regimens including two antibiotics plus acid suppression have become the new standard therapy in Helicobacter pylori eradication because of success rates of about 90 % . However , these regimens are still costly , duration is about one week or less , and side-effects are not negligible . We therefore evaluated a new quadruple therapy , because theoretically a shorter duration of treatment may result in reduced costs , fewer side-effects , and possibly in a lower potential for antibiotic resistances . METHODS Controlled , prospective pilot study including H. pylori-positive patients with gastric or duodenal ulcers or erosive gastritis , treated after failure of dual therapy ( proton-pump-inhibitors or ranitidine plus amoxicillin ) or for the first time . They were assigned to a one week triple standard therapy , consisting of metronidazole 400 mg bid + omeprazole 20 mg bid + clarithromycin 250 mg bid , or a newly created quadruple-regimen , which adds amoxicillin ( 1 g bid ) to the above triple regimen . Each of the four drugs was given for 5 days . H. pylori status was checked by 13C urea breath test before and after four weeks of therapy . RESULTS A total of 71 patients were treated by quadruple therapy , and 42 patients were treated by triple therapy . The eradication rate of H. pylori for patients under quadruple treatment , without vs. with previous dual therapy , were 96 % vs. 92 % ( 42/44 vs. 22/24 ) by per protocol and 91 % vs. 88 % ( 42/46 vs. 22/25 ) by intention to treat analysis ( comparisons not significant ) . No major side-effects were reported . CONCLUSIONS Five-day quadruple therapy ( with omeprazole , metronidazole , clarithromycin and amoxicillin ) represents an effective and safe new regimen for H. pylori eradication .
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Intervention_Pharmacological
one week triple standard therapy , consisting of metronidazole 400 mg bid + omeprazole 20 mg bid + clarithromycin 250 mg bid , or a newly created quadruple-regimen , which adds amoxicillin ( 1 g bid ) to the above triple regimen .
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Outcome_Physical
Helicobacter pylori eradication
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Outcome_Physical
13C urea breath test
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Outcome_Other
eradication rate
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Participant_Condition
Helicobacter pylori
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Participant_Condition
H. pylori-positive
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Participant_Condition
gastric or duodenal ulcers or erosive gastritis
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Participant_Sample-size
71
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Participant_Sample-size
42