Azithromycin in a triple therapy for H.pylori eradication in active duodenal ulcer  

作　　者：Vladimir T.Ivashkin Tatiana L.Lapina Oksana Yu.Bondarenko Olga A. Sklanskaya Petr Va.Grigoriev Yuri V.Vasiliev Emilia P.Yakovenko Pavel V.Gulyaev Valeri I.Fedchenko 

机构地区：[1]V.Vasilenko Clinic of internal diseases,gastroenterology and hepatology of the Moscow Sechenov Medical Academy,119881 Pogodinskaya 5,Moscow,Russia [2]Pathology Department of the Moscow Sechenov Medical Academy,119881,Trubetskaya 8,Moscow,Russia [3]Gastroenterological Center of the Health Ministry of Russia,105203,N.Pervomayskaya ul.70,Moscow,Russia [4]Central Institution of Gastroenterology,111123,Sh.Entusiastov 86,Moscow,Russia

出　　处：《World Journal of Gastroenterology》2002年第5期879-882,共4页世界胃肠病学杂志（英文版）

基　　金：PLIVA(Croatia).

摘　　要：AIM:To assess and compare the efficacy and safety of two triple regimes:A)metronidazole,amoxicillin and omeprazole, which is still widely used in Russia,and B)azithromycin, amoxicillin and omeprazole in healing active duodenal ulcer and H.pylori eradication. METHODS:100 patients with active duodenal ulcer were included in the open,multicentre,randomized study with comparative groups.Patients were randomly assigned to one of the following one-week triple regimes:A) metronidazole 500 mg bid,amoxicillin I g bid and omeprazole 20 mg bid(OAM,n=50)and B)azithromycin 1 god for the first 3 days(total dose 3 g),amoxicillin 1 g bid and omeprazole 20 mg bid(OAA,n=50).Omeprazole 20 mg od was given after the eradication course as a monotherapy for three weeks.The control endoscopy was performed 8 weeks after the entry.H.pyloriinfection was determined in the entry of the study and four weeks after the cessation of treatment by means of histology and CLO-test. RESULTS:97 patients completed the study according to the protocol(1 patient of the OAM group did not come to the control endoscopy,2 patients of the OAA group stopped the treatment because of mild allergic urticaria).Duodenal ulcers were healed in 48 patients of the OAM group(96 %, C190.5-100 %)and in 46 patients of the OAA group(92 %, CI 89.5-94.5 %)(p=ns).H.pyloHinfection was eradicated in 15 out of 50 patients with OAM(30 %,CI 17-43 %)and in 36 out of 50 patients treated with OAA(72 %;CI 59-85 %) (P<0.001)-ITT analysis.CONCLUSION: The triple therapy with omeprazole, amoxicillin and metronidazole failed to eradicate H.pylori'vc\ the majority of patients, which is an essential argument to withdraw this regimen out of the national recommendations. Macrolide with amoxicillin are preferable to achieve higher eradication rates. Azithromycin (1 g od for the first 3 days) can be considered as a successful component of the triple PPI-based regimen.AIM：To assess and compare the efficacy and safety of two triple regimes:A)metronidazole,amoxicillin and omeprazole,which is still widely used in Russia,andB)azithromycin amoxicillin and omeprazole in healing active duodenal ulcer and H.pylori eradication.METHODS:100 patients with active duodenal ulcer were includid in the open,multicentre,randomized study with comparative groups.Patients were randomly assigned to one of the following one-week triple regimes:A)metronidazole500mg bid,amoxicillin1gbid and omeprazole 20mg bid(OAM,n=50)andB)azithromycin1g od for the first3days(total dose3g).amoxicillin 1g bid and first 3days(total dose3g).amoxicillin 1g bid and omeprazole20mg bid(OAA,n=50).Omeprazole 20mg od was given after the eradication course as a monotherapy for three weeks ,The control endoscopy was performed8 weeks after the entry,H.pyloriinfection was determined in the entry of the study and four weeks after the cessation of treatment by means of histology and CLO-test.RESULTS:97 patients completed the study according to the protocol(1patient of the OAM group did not come to the control endoscopy.2patients of the OAA group stopped the treatment because of mild allergic urticaria).Duodenal ulcers were healed in48patients of the OAM group(96%;CI90.5-100%)and in 46patients of the OAAgroup(92%;CI89.5-94.5%)(p=ns).H.pylori infection was eradicated in 15out of 50patients with OAM(30%;CI17-43%)and in36out of 50patients treated with OAA(72%,CI59-85%)(P<0.001)-IПanalysis.CONCLUSION:The triple therapy with omeprazole,amoxicillin and metronidazole failed to eradicateH.pylori in the majorty of patients,which is an essential argument to withdraw this regimen out of the national recommendations,Macrolide with amoxicillin are preferable to achieve higher eradication rates.Azitromycin(1g od for the first3days)can be considered as a successful component of the triple PPI-based regimen.

关 键 词：Helicobacter pylori Adolescent Adult Aged AMOXICILLIN dosage Anti-Bacterial Agents Anti-Ulcer Agents AZITHROMYCIN Comparative Study Drug Therapy  Combination Duodenal Ulcer Female Helicobacter Infections Humans Male METRONIDAZOLE Middle Aged OMEPRAZOLE PENICILLINS Research Support  Non-U.S. Gov't Treatment Outcome 

分 类 号：R573.1[医药卫生—消化系统]