Factors affecting Helicobacter pylori eradication using a seven-day triple therapy with a proton pump inhibitor, tinidazole and clarithromycin, in brazilian patients with peptic ulcer

  • Fernando Marcuz Silva University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Gastroenterology
  • Schlioma Zaterka University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Gastroenterology
  • Jaime Natan Eisig University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Gastroenterology
  • Ethel Zimberg Chehter University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Gastroenterology
  • Décio Chinzon University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Gastroenterology
  • Antonio Atílio Laudanna University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Gastroenterology
Keywords: Peptic Ulcer Treatment, Helicobacter pylori Eradication, Proton pump inhibitor, Tinidazole, Clarithromycin

Abstract

Triple therapy is accepted as the treatment of choice for H. pylori eradication. In industrialized countries, a proton pump inhibitor plus clarithromycin and amoxicillin or nitroimidazole have shown the best results. Our aims were: 1. To study the eradication rate of the association of a proton pump inhibitor plus tinidazole and clarithromycin on H. pylori infection in our population. 2. To determine if previous treatments, gender, age, tobacco, alcohol use, and non-steroidal anti-inflammatory drugs (NSAIDs) change the response to therapy. METHODS: Two hundred patients with peptic ulcer (upper endoscopy) and H. pylori infection (histology and rapid urease test - RUT) were included. A proton pump inhibitor (lansoprazole 30 mg or omeprazole 20 mg), tinidazole 500 mg, and clarithromycin 250 mg were dispensed twice a day for a seven-day period. Eradication was assessed after 10 to 12 weeks of treatment through histology and RUT. RESULTS: The eradication rate of H. pylori per protocol was 65% (128/196 patients). This rate was 53% for previously treated patients, rising to 76% for not previously treated patients, with a statistical difference p<0.01. No significant difference was observed regarding sex, tobacco use, alcohol consumption, and NSAID use, but for elderly patients the difference was p = 0.05. Adherence to treatment was good, and side effects were mild. CONCLUSIONS: A proton pump inhibitor, tinidazole, and clarithromycin bid for seven days resulted in H. pylori eradication in 65% of the patients. Previous treatments were the main cause of treatment failure.
Published
2001-01-01
How to Cite
Silva, F., Zaterka, S., Eisig, J., Chehter, E., Chinzon, D., & Laudanna, A. (2001). Factors affecting Helicobacter pylori eradication using a seven-day triple therapy with a proton pump inhibitor, tinidazole and clarithromycin, in brazilian patients with peptic ulcer . Revista Do Hospital Das Clínicas, 56(1), 11-16. https://doi.org/10.1590/S0041-87812001000100003
Section
Original Articles