Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting?

Authors

  • Pedro Boal Carvalho Serviço de Gastrenterologia. Hospital da Senhora da Oliveira. Guimarães. Portugal.
  • Joana Magalhães Serviço de Gastrenterologia. Hospital da Senhora da Oliveira. Guimarães. Portugal.
  • Francisca Dias de Castro Serviço de Gastrenterologia. Hospital da Senhora da Oliveira. Guimarães. Portugal.
  • Bruno Rosa Serviço de Gastrenterologia. Hospital da Senhora da Oliveira. Guimarães. Portugal.
  • José Cotter Serviço de Gastrenterologia. Hospital da Senhora da Oliveira. Guimarães. Portugal. Life and Health Sciences Research Institute. School of Health Sciences. Universidade do Minho. Braga. Portugal. ICVS/3B’s. PT Government Associate Laboratory. Guimarães/Braga. Portugal.

DOI:

https://doi.org/10.20344/amp.8072

Keywords:

Anti-Bacterial Agents, Drug Therapy, Combination, Helicobacter Infections/drug therapy, Helicobacter pylori, Portugal, Stomach Neoplasms

Abstract

Introduction: Helicobacter pylori eradication has become increasingly difficult as resistances to several antibiotics develop. We aimed to compare Helicobacter pylori eradication rates between triple therapy and sequential therapy in a naive Portuguese population.
Material and Methods: Prospective randomized trial including consecutive patients referred for first-line Helicobacter pylori eradication treatment. Exclusion criteria: previous gastric surgery/neoplasia, pregnancy/lactancy, allergy to any of the drugs. The compared eradication regimens were triple therapy (pantoprazol, amoxicillin and clarithromycin 12/12 hours, 14 days) and sequential therapy (pantoprazol 12/12 hours for 10 days, amoxicillin 12/12 hours for days 1 - 5 and clarithromycin plus metronidazol 12/12 hours during days 6 - 10). Eradication success was confirmed with urea breath test. Statistical analysis was performed with SPSS v21.0 and a p-value < 0.05 was considered statistically significant.
Results: Included 60 patients, 39 (65%) female with mean age 52 years (SD ± 14.3). Treatment groups were homogeneous for gender, age, indication for treatment and smoking status. No statistical differences were encountered between sequential and triple therapy eradication rates (86.2% vs 77.4%, p = 0.379), global eradication rate was 82%. Tobacco consumption was associated with a significantly lower eradication success (54.5 vs 87.8%, p = 0.022).
Discussion: In this randomized controlled trial in a naive Portuguese population, we found a satisfactory global Helicobacter pylori eradication rate of 82%, with no statistical differences observed in the efficacy of the treatment between triple and sequential regimens.
Conclusion: These results support the use of either therapy for the first-line eradication of Helicobacter pylori.

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Published

2017-03-31

How to Cite

1.
Boal Carvalho P, Magalhães J, Dias de Castro F, Rosa B, Cotter J. Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting?. Acta Med Port [Internet]. 2017 Mar. 31 [cited 2023 Feb. 6];30(3):185-9. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/8072

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Section

Original