Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/6894
Citations | ||
Scopus | Web of ScienceĀ® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Randomized trial of omeprazole and metronidazole with amoxycillin or clarithromycin for Helicobacter pylori eradication, in a region of high primary metronidazole resistance: the HERO study |
Author: | Katelaris, P. Adamthwaite, D. Midolo, P. Yeomans, N. Davidson, G. Lambert, J. |
Citation: | Alimentary Pharmacology and Therapeutics, 2000; 14(6):751-758 |
Publisher: | Blackwell Science Ltd |
Issue Date: | 2000 |
ISSN: | 0269-2813 1365-2036 |
Statement of Responsibility: | Katelaris, Adamthwaite, Midolo, Yeomans, Davidson and Lambert for the HERO study group |
Abstract: | <h4>Background</h4>The efficacy of omeprazole-based eradication therapies has been determined mostly in populations with low to moderate prevalence of metronidazole resistant Helicobacter pylori, yet resistance is high in many regions.<h4>Aim and methods</h4>The H. pylori eradication and duodenal ulcer healing rates after 1 week of either omeprazole 40 mg mane, amoxycillin 500 mg t.d.s. and metronidazole 400 mg t.d.s. (OAM) or omeprazole 20 mg b.d., metronidazole 400 mg b. d. and clarithromycin 250 mg b.d. (OMC) were compared in a randomized trial in Australia and New Zealand. Patients had a further 1 week of omeprazole 20 mg. Outcome was assessed at 6 weeks with stringent criteria (endoscopy, biopsies and 13C-urea breath test).<h4>Results</h4>Of 220 subjects randomized, the H. pylori eradication rates (all patients treated/per protocol) were 82%/85% for OMC and 58%/63% for OAM (P= 0.001). Pre-treatment metronidazole resistance was present in 56% and clarithromycin resistance in 6%. The eradication rate for primary metronidazole resistance isolates treated with OMC was 80% (CI: 65-90%) compared with 45% (CI: 29-62%) for OAM, whereas for sensitive organisms, the eradication rates were 94% (CI: 79-99%) and 79% (CI: 62-91%), respectively. Duodenal ulcer healing was 96% for OMC and 87% for OAM. Compliance was excellent and both treatments were well-tolerated.<h4>Conclusions</h4>OMC is a well-tolerated, effective therapy for H. pylori eradication and duodenal ulcer healing in this region despite the high metronidazole resistance rate. OAM is less effective, largely due to the impact of metronidazole resistance. |
Keywords: | Humans Helicobacter pylori Helicobacter Infections Duodenal Ulcer Penicillins Amoxicillin Clarithromycin Metronidazole Omeprazole Anti-Bacterial Agents Treatment Outcome Drug Therapy, Combination Drug Resistance Adolescent Adult Aged Middle Aged Female Male |
DOI: | 10.1046/j.1365-2036.2000.00776.x |
Published version: | http://dx.doi.org/10.1046/j.1365-2036.2000.00776.x |
Appears in Collections: | Aurora harvest Paediatrics publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.