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- Title
Sequential therapy using high-dose esomeprazole-amoxicillin followed by gatifloxacin for Helicobacter pylori infection.
- Authors
GRAHAM, D. Y.; ABUDAYYEH, S.; EL‐ZIMAITY, H. M. T.; HOFFMAN, J.; REDDY, R.; OPEKUN, A. R.
- Abstract
Background The success rate of current anti- Helicobacter pylori triple therapies in now generally 80% or less. Sequential therapy has proved superior. Aim To test a new sequential therapy for H. pylori eradication. Methods This was a pilot study of a sequential therapy consisting of 40 mg of esomeprazole and 1 g amoxicillin t.d.s., for 12 days. On days 6 through 12 gatifloxacin (400 mg in the morning) was added. Outcome was accessed 4 or more weeks after ending antibiotic therapy. Both naive and treatment failures were eligible. Results Thirty patients were entered in the study. One was lost to follow-up and one stopped early because of side effects. The success rate intention-to-treat was 80.7 (95% CI: 61-92%). The per-protocol eradication rate was 85.7% (95% CI: 67-95%); two of the four failures had pre-treatment gatifloxacin-resistant H. pylori. Side effects were reported by 13 patients (46%) and were generally mild with diarrhoea being most common (n = 6). Only one patient stopped medicine because of side effects of dizziness (severe) and diarrhoea (mild). Conclusions Sequential therapy using the combination of a high dose of proton-pump inhibitor and amoxicillin followed gatifloxacin was effective, but pre-treatment susceptibility testing may become necessary as fluoroquinolone resistance increases.
- Subjects
HELICOBACTER pylori infections; THERAPEUTICS; ESOMEPRAZOLE; AMOXICILLIN; DRUG side effects; PATIENTS; DIARRHEA; HELICOBACTER diseases
- Publication
Alimentary Pharmacology & Therapeutics, 2006, Vol 24, Issue 5, p845
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/j.1365-2036.2006.03072.x