Highly Effective Second-Line Anti-Helicobacter pylori Therapy in Patients with Previously Failed Metronidazole-Based Therapy

F. Lerang Dept. of Internal Medicine and Dept. of Microbiology, Østfold Central Hospital, Fredrikstad, Norway; Dept. of Internal Medicine, Halden Hospital, Halden, Norway; Dept. of Internal Medicine, Østfold Central Hospital, Sarpsborg, Norway; Dept. of Internal Medicine, Hedmark Central Hospital, Hamar, Norway; Dept. of Internal Medicine, Kongsberg Hospital, Kongsberg, Norway

B. Moum Dept. of Internal Medicine and Dept. of Microbiology, Østfold Central Hospital, Fredrikstad, Norway; Dept. of Internal Medicine, Halden Hospital, Halden, Norway; Dept. of Internal Medicine, Østfold Central Hospital, Sarpsborg, Norway; Dept. of Internal Medicine, Hedmark Central Hospital, Hamar, Norway; Dept. of Internal Medicine, Kongsberg Hospital, Kongsberg, Norway

J. B. Haug Dept. of Internal Medicine and Dept. of Microbiology, Østfold Central Hospital, Fredrikstad, Norway; Dept. of Internal Medicine, Halden Hospital, Halden, Norway; Dept. of Internal Medicine, Østfold Central Hospital, Sarpsborg, Norway; Dept. of Internal Medicine, Hedmark Central Hospital, Hamar, Norway; Dept. of Internal Medicine, Kongsberg Hospital, Kongsberg, Norway

T. Berge Dept. of Internal Medicine and Dept. of Microbiology, Østfold Central Hospital, Fredrikstad, Norway; Dept. of Internal Medicine, Halden Hospital, Halden, Norway; Dept. of Internal Medicine, Østfold Central Hospital, Sarpsborg, Norway; Dept. of Internal Medicine, Hedmark Central Hospital, Hamar, Norway; Dept. of Internal Medicine, Kongsberg Hospital, Kongsberg, Norway

P. Tolas Dept. of Internal Medicine and Dept. of Microbiology, Østfold Central Hospital, Fredrikstad, Norway; Dept. of Internal Medicine, Halden Hospital, Halden, Norway; Dept. of Internal Medicine, Østfold Central Hospital, Sarpsborg, Norway; Dept. of Internal Medicine, Hedmark Central Hospital, Hamar, Norway; Dept. of Internal Medicine, Kongsberg Hospital, Kongsberg, Norway

P. K. Sandvei Dept. of Internal Medicine and Dept. of Microbiology, Østfold Central Hospital, Fredrikstad, Norway; Dept. of Internal Medicine, Halden Hospital, Halden, Norway; Dept. of Internal Medicine, Østfold Central Hospital, Sarpsborg, Norway; Dept. of Internal Medicine, Hedmark Central Hospital, Hamar, Norway; Dept. of Internal Medicine, Kongsberg Hospital, Kongsberg, Norway

R. Torp Dept. of Internal Medicine and Dept. of Microbiology, Østfold Central Hospital, Fredrikstad, Norway; Dept. of Internal Medicine, Halden Hospital, Halden, Norway; Dept. of Internal Medicine, Østfold Central Hospital, Sarpsborg, Norway; Dept. of Internal Medicine, Hedmark Central Hospital, Hamar, Norway; Dept. of Internal Medicine, Kongsberg Hospital, Kongsberg, Norway

T. Tønnesen Dept. of Internal Medicine and Dept. of Microbiology, Østfold Central Hospital, Fredrikstad, Norway; Dept. of Internal Medicine, Halden Hospital, Halden, Norway; Dept. of Internal Medicine, Østfold Central Hospital, Sarpsborg, Norway; Dept. of Internal Medicine, Hedmark Central Hospital, Hamar, Norway; Dept. of Internal Medicine, Kongsberg Hospital, Kongsberg, Norway

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Abstract

Background: In this study we compared the cure rates of two clarithromycin-based regimens in patients in whom anti-Helicobacter pylori therapy had previously failed. Methods: Thirty-three patients were randomized to receive either regimen OAC (20 mg omeprazole, 750 mg amoxicillin, and 250 mg clarithromycin) or BTC (240 mg bismuth subcitrate, 750 mg oxytetracycline, and 250 mg clarithromycin), all twice daily for 10 days. A further 28 patients were all treated with OAC. Previously failed therapy included combinations of bismuth (B), omeprazole (O), tetracycline (T), metronidazole (M), amoxicillin (A), or clarithromycin (C) in BTM (n = 48), OAM (n = 13), OA (n = 7), OCM (n = 2), or BCM (n = 1). H. pylori infection was confirmed by culture of biopsy specimens, and antimicrobial susceptibility testing was performed with the E test. Results: H. pylori infection was cured in all patients (n = 18) with OAC and in 8 patients (53%) with BTC (P = 0.001) in the randomized group and in 27 patients (96%) receiving OAC in the open-label group. Conclusions: Ten-day OAC is highly effective and superior to BTC in patients in whom metronidazole-based treatment has previously failed.

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Highly Effective Second-Line Anti-Helicobacter pylori Therapy in Patients with Previously Failed Metronidazole-Based Therapy

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Highly Effective Second-Line Anti-Helicobacter pylori Therapy in Patients with Previously Failed Metronidazole-Based Therapy

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