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Salvage therapy after two or more prior Helicobacter pylori treatment failures: the super salvage regimen.
MP. Dore, L. Marras, E. Maragkoudakis, S. Nieddu, A. Manca, DY. Graham, G. Realdi
Helicobacter 2003 Aug;8(4):307-9.
PubMed: 12950603
Abstract
Although effective therapies are available for curing Helicobacter pylori infection, the problem persists about what to do for patients who fail two or more treatment courses despite a good compliance. To test a twice a day midday quadruple therapy as salvage therapy. Dyspeptic H. pylori-infected patients who failed two or more courses of anti-H. pylori therapy received omeprazole 20 mg, tetracycline 500 mg, metronidazole 500 mg, and bismuth subcitrate caplets 240 mg twice a day (with the midday and evening meals) for 14 days. H. pylori status was evaluated by 13C-urea breath test and histology 4-6 weeks after therapy. Eradication was defined as no positive test. Seventy-one patients were enrolled and 68 completed the full 14 days of therapy (mean age 46 years; 28 men). Thirty-three patients had failed prior treatment twice, 19 had failed three times, and 16 had failed four or more times. The cure rates were: intention to treat=93% (66/71); (95% CI=84% to 98%), per protocol=97% (66/68); (95% CI=89%- 100%). Success was excellent irrespective of diagnosis, age, prior treatment protocols, or smoking status. Moderate side-effects were experienced by only two patients. Midday bismuth subcitrate based twice a day quadruple therapy was an excellent salvage therapy. BID midday quadruple regimen should be considered as the therapy of choice.
Associated compounds:
Compound Name
with link to compound page |
Structure | Number of references |
---|---|---|
Urea | 1130 |