High Effectiveness of a 14-Day Concomitant Therapy for Helicobacter pylori Treatment in Primary Care. An Observational Multicenter Study

Background: The current cure rates with triple therapy combining a proton-pump inhibitor, amoxicillin and clarithromycin are unacceptably low. Aims: To evaluate the efficacy of a 14-day concomitant therapy as an empirical first-line treatment for curing Helicobacter pylori (Hp) infection in primary...

Descripción completa

Detalles Bibliográficos
Autores principales: Olmedo, Llum, Azagra, Rafael, Aguyé, Amada, Pascual, Marta, Calvet, Xavier, Gené, Emili
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464342/
https://www.ncbi.nlm.nih.gov/pubmed/32731455
http://dx.doi.org/10.3390/jcm9082410
_version_ 1783577342655856640
author Olmedo, Llum
Azagra, Rafael
Aguyé, Amada
Pascual, Marta
Calvet, Xavier
Gené, Emili
author_facet Olmedo, Llum
Azagra, Rafael
Aguyé, Amada
Pascual, Marta
Calvet, Xavier
Gené, Emili
author_sort Olmedo, Llum
collection PubMed
description Background: The current cure rates with triple therapy combining a proton-pump inhibitor, amoxicillin and clarithromycin are unacceptably low. Aims: To evaluate the efficacy of a 14-day concomitant therapy as an empirical first-line treatment for curing Helicobacter pylori (Hp) infection in primary care. Methods: Patients from six primary care centers in Catalonia -Spain- were included consecutively. Hp status pre and post treatment was assessed according to local clinical practice protocol. A 14-day concomitant therapy (amoxicillin 1 g, clarithromycin 500 mg and metronidazole 500 mg plus omeprazole 20 mg, all drugs administered twice daily) was prescribed. Adherence to therapy and adverse events were assessed by personal interview. Results: 112 patients were enrolled. Mean age was 46.7 ± 16.1 years. Main indication for treatment was non-investigated dyspepsia (83%). Hp eradication was achieved in 100 of the 112 patients. Eradication rates were 89.3% (95% CI: 81.7–94.1) by intention-to-treat (ITT) analysis and 91.7% (95% CI; 84.6–95.9) per protocol (PP). No major side effects were reported; 104 (92.8%) patients complete the treatment. Forty-seven patients (42%) complained of mild side effects (metallic taste, nausea). Low adherence to treatment (p = 0.004) and significant adverse events (p = 0.004) were the variables associated with treatment failure. Conclusions: In primary care, a 14-day concomitant therapy is highly effective and well tolerated.
format Online
Article
Text
id pubmed-7464342
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-74643422020-09-04 High Effectiveness of a 14-Day Concomitant Therapy for Helicobacter pylori Treatment in Primary Care. An Observational Multicenter Study Olmedo, Llum Azagra, Rafael Aguyé, Amada Pascual, Marta Calvet, Xavier Gené, Emili J Clin Med Article Background: The current cure rates with triple therapy combining a proton-pump inhibitor, amoxicillin and clarithromycin are unacceptably low. Aims: To evaluate the efficacy of a 14-day concomitant therapy as an empirical first-line treatment for curing Helicobacter pylori (Hp) infection in primary care. Methods: Patients from six primary care centers in Catalonia -Spain- were included consecutively. Hp status pre and post treatment was assessed according to local clinical practice protocol. A 14-day concomitant therapy (amoxicillin 1 g, clarithromycin 500 mg and metronidazole 500 mg plus omeprazole 20 mg, all drugs administered twice daily) was prescribed. Adherence to therapy and adverse events were assessed by personal interview. Results: 112 patients were enrolled. Mean age was 46.7 ± 16.1 years. Main indication for treatment was non-investigated dyspepsia (83%). Hp eradication was achieved in 100 of the 112 patients. Eradication rates were 89.3% (95% CI: 81.7–94.1) by intention-to-treat (ITT) analysis and 91.7% (95% CI; 84.6–95.9) per protocol (PP). No major side effects were reported; 104 (92.8%) patients complete the treatment. Forty-seven patients (42%) complained of mild side effects (metallic taste, nausea). Low adherence to treatment (p = 0.004) and significant adverse events (p = 0.004) were the variables associated with treatment failure. Conclusions: In primary care, a 14-day concomitant therapy is highly effective and well tolerated. MDPI 2020-07-28 /pmc/articles/PMC7464342/ /pubmed/32731455 http://dx.doi.org/10.3390/jcm9082410 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Olmedo, Llum
Azagra, Rafael
Aguyé, Amada
Pascual, Marta
Calvet, Xavier
Gené, Emili
High Effectiveness of a 14-Day Concomitant Therapy for Helicobacter pylori Treatment in Primary Care. An Observational Multicenter Study
title High Effectiveness of a 14-Day Concomitant Therapy for Helicobacter pylori Treatment in Primary Care. An Observational Multicenter Study
title_full High Effectiveness of a 14-Day Concomitant Therapy for Helicobacter pylori Treatment in Primary Care. An Observational Multicenter Study
title_fullStr High Effectiveness of a 14-Day Concomitant Therapy for Helicobacter pylori Treatment in Primary Care. An Observational Multicenter Study
title_full_unstemmed High Effectiveness of a 14-Day Concomitant Therapy for Helicobacter pylori Treatment in Primary Care. An Observational Multicenter Study
title_short High Effectiveness of a 14-Day Concomitant Therapy for Helicobacter pylori Treatment in Primary Care. An Observational Multicenter Study
title_sort high effectiveness of a 14-day concomitant therapy for helicobacter pylori treatment in primary care. an observational multicenter study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464342/
https://www.ncbi.nlm.nih.gov/pubmed/32731455
http://dx.doi.org/10.3390/jcm9082410
work_keys_str_mv AT olmedollum higheffectivenessofa14dayconcomitanttherapyforhelicobacterpyloritreatmentinprimarycareanobservationalmulticenterstudy
AT azagrarafael higheffectivenessofa14dayconcomitanttherapyforhelicobacterpyloritreatmentinprimarycareanobservationalmulticenterstudy
AT aguyeamada higheffectivenessofa14dayconcomitanttherapyforhelicobacterpyloritreatmentinprimarycareanobservationalmulticenterstudy
AT pascualmarta higheffectivenessofa14dayconcomitanttherapyforhelicobacterpyloritreatmentinprimarycareanobservationalmulticenterstudy
AT calvetxavier higheffectivenessofa14dayconcomitanttherapyforhelicobacterpyloritreatmentinprimarycareanobservationalmulticenterstudy
AT geneemili higheffectivenessofa14dayconcomitanttherapyforhelicobacterpyloritreatmentinprimarycareanobservationalmulticenterstudy