Sivri Bulent, Simsek Ilkay, Hulagu Saadettin, Kadayifci Abdurrahman, Tozun Nurdan, Akarsu Mesut, Uraz Suleyman, Savas M Cemil, Koruk Mehmet, Bozbas Aysun
Department of Gastroenterology, Faculty of Medicine, Hacettepe University Ankara, Turkey.
Curr Med Res Opin. 2004 Aug;20(8):1301-7. doi: 10.1185/030079904125004439.
Recently, proton pump inhibitor (PPI)-based triple therapy has been recommended as a first line treatment in the eradication of Helicobacter pylori. The aim of this open, multicentre trial was to investigate the efficacy, safety, tolerability and the ulcer healing rate of a triple regimen consisting of pantoprazole 40 mg, clarithromycin 500 mg and amoxicillin 1000 mg twice daily for 7 days, in the eradication of H. pylori in patients with duodenal ulcer in Turkey.
H. pylori infection was assessed by histological examination and rapid urease test at baseline and 4 weeks after the completion of the therapy. Seventy-seven patients were enrolled, 5 were excluded due to various reasons and 72 completed the entire course of the trial.
H. pylori eradication was confirmed in 49 of these patients; the eradication rate was 68% by per-protocol analysis and 63.6% by intention-to-treat analysis. The ulcers were completely healed in 61 patients (85%) at the second endoscopic examination. Drug compliance was excellent (97.3%) and there were no serious adverse events.
Pantoprazole-based 1-week triple therapy was well tolerated and the ulcer healing rate was high (85%). Relatively low H. pylori eradication rates may be attributed to rising antibiotic resistance over recent years. A large scale, comparative study with other PPI-based regimens is warranted based on the results of this open study with the pantoprazole-based regimen.
近期,基于质子泵抑制剂(PPI)的三联疗法已被推荐作为根除幽门螺杆菌的一线治疗方案。本开放性多中心试验的目的是研究一种由泮托拉唑40毫克、克拉霉素500毫克和阿莫西林1000毫克组成的三联方案,每日两次,共7天,在土耳其十二指肠溃疡患者中根除幽门螺杆菌的疗效、安全性、耐受性及溃疡愈合率。
在基线及治疗结束后4周,通过组织学检查和快速尿素酶试验评估幽门螺杆菌感染情况。共纳入77例患者,5例因各种原因被排除,72例完成了整个试验疗程。
其中49例患者的幽门螺杆菌被证实已根除;按符合方案分析,根除率为68%,按意向性分析,根除率为63.6%。在第二次内镜检查时,61例患者(85%)的溃疡完全愈合。药物依从性良好(97.3%),且无严重不良事件。
基于泮托拉唑的1周三联疗法耐受性良好,溃疡愈合率高(85%)。幽门螺杆菌根除率相对较低可能归因于近年来抗生素耐药性的上升。基于这项泮托拉唑方案开放性研究的结果,有必要开展一项与其他基于PPI方案的大规模对照研究。