The efficacy of triple and quadruple therapy for thetreatment of peptic ulcer disease
DOI:
https://doi.org/10.25130/tjphs.2005.1.5.36.44Abstract
This study was designed to determine the efficacy of triple and quadruple therapy for the treatment of peptic ulcer disease. Seventy five patients underwent Helicobacter Pylori associated peptic ulcer ,as determined by endoscopy and rapid urease test of biopsy were paiiicipated in this study. They were divided to 4 groups. Three of them were treated with triple therapy. The triple therapy in the first group consisted of omprazole 20 mg BID + amoxicillin 500 mg QID + metronidazole 500 mg TID . For the second group , only omprazole was replaced by ranitidine 150 mg BID , while for the third group metronidazole was replaced by clarithromycin 500mg BID . All triple therapies were given for 2 weeks. However , for the fourth group , a quadruple therapy consisted of omprazole 20mg BID + amoxicillin 500mg QID + clarithromycin 500mg BID + metronidazole 500mg TID , was given for one week. The efficacy in the four groups, was 91.3, 88.89, 90, and 100% respectively. All treatmentregimens were well tolerated and no sever side effects necessitated cessation of the treatment.
References
-Hart, C. A; Murray, A. E. and Walker, S. G. Campylobacter pylori and gastnt1s. Microbiology 2002; 12(11): 500-504.
- Norman B. An Introduction to the symptoms and signs of surgical diseases .Edward Arnold ,London U.K.1988 pp 336-338.
- Graham, D. Y.; Rakel, R. E.; Fendrick, A. M. et al .Recognizing peptic ulcer disease: Key to clinical and laboratory diagnosis .Post Graduate Medicine.1999;105(3):113- 133.
- Matin, A.; Zuchlinsky, E.; Keyhan,M. and Sachs, G. Capacity of Helicobacter pylori to generate ionic gradients at low Ph in similar to that of bacteria which grow under strongly acidic conditions. Infect. Immun. 1996 ;64: 1434-1436.
- Labigne, A. and Reuse, H. Determination of Helicobacter pylori pathogenicity .Infect .Agent Disease .1996; 5: 191-202.
- Al-Karawi, M. A. Helicobacter pylori : revising our concepts of the pathophysiology and management of peptic ulcer disease. Saudi Med. J. 1997; 18(2): 127-129.
- Jurg Metzger, M.; Stephan, S. Markus, V. F.; Peter, V. and Felix, H. Prevalence of Helicobacter pylori infection in peptic ulcer perforation. Swiss Med. Wkly.2001; 131: 99-103.
-Mark, F.;Harrison, R. R.; James,S. and Com1ie, S. Peptic ulcer disease. Umhs Peptic Ulcer Guideline. 1999 May; 1-6
- Iwasaki, A. Eradication rate and side effect from a point of view of Helicobacter pylori eradication of peptic ulcer disease in dual therapy or new triple therapy. Nippon-Rinsho. 1999; 57(1) : 127-23.
- Wurzer, H.; Rodrigo, L.; Stamler, D.; Archambault, A.; Rokkas, T. ;Skandalis, N. et al. Short · ·course therapy with amoxicillin
clarithromycin triple therapy for 10 days( ACT-10) eradicates He! icobacter pylori .and heals duodeô€™al ulcer. Aliment. Pharmacol. Ther. 1997; 11 : 943 -952.
Carrido, A.; Lepe, J. A.;Guerrero, F. J. and Palomo,S. Eradication of Helicobacter pylori by triple therapy in ulcerous patients : role of endoscopy and antibiotic sensitivity. Infec. Microbiol.Clin.1998 ; 16(10) : 471-473.
-Lind, T.; Veldhuzyen vanZanten, S.; Uuge, P.; piller, R.; Bayerderffer, E.; Omorain,C. et al. Eradication of Helicobacter pylori using one-week triple therapy combing omeprazole and two antibiotic. Helicobacter 1996 ; 1: 138-144
- Miwa,H.; Ohkura,R.; Murai,T.; Sato,K.; Nagahara,A.; Hirai,S.; Sato,N.; Watanabe, S. Impact of rabeprazole, a new proton pump inhibitor ,m triple therapy for Helicobacter pylori infection companson with omeprazole and lansoprazole. Aliment. Pharmacol. Ther. 1999 ; 13(6) 741-6.
- Habu,Y.; Kiyota,K.; Inokuchi,H.; Sugano,Y.; Ko,K. and Waki, S. Evaluation of the efficacy and the cost effectiveness of proton pump Inhibitor based dual and triple therapy regimens for Helicobacter pylori eradication in peptic ulcer disease. Nippon Rinsho.1999; 57 (1) : 135-9.
- Mizanur Rahman, H.A.M.; Nazmul,A. and Delowar,H. Nonoperative management of perforated peptic ulcer. Pak J. Med. Sci .2003 ; 19(2): 101-105.
- Lerang,F.; Moum,B.; Hang, J. B.; Berge, T.; Talas, P. ; Sandevie, P. K.; Torp,R.; and Tom1eson,T. Highly effective second line anti-Helicobacter Pylori therapy in patient with previous fail metronidazole therapy. Scand J. Gastroenterol. 1997;32: 1209-1214.
- The European Helicobacter pylori Study Group .Current European concepts in the management of Helicobacter pylori infection . The Mastricht ·consensus report . Gut 1997 ;_ 41:8-13
- Kirstein, F. W.; Epple, H. J.; Bojarski, C.; Victor, L.; Fromm, M.; Riecken, E. O.; and Schulzke, J. D. Dual versus triple therapy : comparison of five antibiotic regimens for eradication of Helicobacter pylori in a prospective, randomized study. Z. Gastroenterol. 1998; 36(9): 803-9.
- Williamson,R.;Pipklin,G.A.; and Wood,J.R. New option in Helicobacter pylori eradication efficacy , resistance and synergy. Scand J. Gastroenterol. 1998(suppl) ; 225: 36-40.
- Romero-Gomez,M.; MartinezÂDelgado,C. ;Grande,L.; Vargas,J.; Otero-Femandez,M.A,; and CastroÂFemandez, M. Intravenous eradication therapy for bleeding gastro-duodenal ulcer associated with Helicobacter pylori infection. Rev. Esp .Enferm . Dig.2000 ;92(6):386-91.
- anp1ero, M.; Antonella, YI.; Claudio,D.N. and Antonio,B. Empirical prescribing for dyspepsia: randomized controlled trial of test and treat versus omeprazole treatment. BMJ. 2003 ; 326 : 1-6.
- Chu,K.M.; Kwok, K.F.; Law, S.Y.;and Wong,J. One week once daily triple therapy for Helicobacter pylori :pilot study. Hepatogasteo enterol. 2000 ; 47(36): 1624-6.
- Miwa,H.; Yamada,T.; Sato,K.; Ohkura,R.; Murai,T.; Nagathara, A.;Takei , Y.;Ogihara,T.; and Sato,N. Efficacy of reduce dosage of
rabeprazole in PPI/ AC therapy for Helicobacter pylori infection
comparison of 20mg and 40mg with 60mg lansoprazole .Dig.Dis.Sci.2000 ; 63(2) : 77-82.
- Dehesa,M.; Larisk,J.; Dibildox,M.; Vega,B.; Di-silvio,M.; Rodriguez,L.; Camorlinga,M.; Almaguer,!.; RabirezBarba,E.; and Torres,J. Comparison of 2 schedules based on pantoprazole eradication of H.pylori in patient with active duodenal ulcer Rev. Gastroenterol. Mex.1998; 63(2):66-71.
-Chey, W.D., Fisher, L., Barnett, J., Delvalle, J., Elta, G.H., Hasler, W.L., Nostrant, T., Palaniappan, J. and Sheiman, J., Low-versus high-dose azithromycin triple therapy for. Helicobacter pylori, pp.1263-7.
- Nijevitch, A. A.; Farztidinov, K. M.; Sataer, V. U.; Khasanov, R. Sh.; Katayer, V. A.; Khusnutdinov, S. M.; Akhunov,E.D.; and Kazykhanov,N.S. J lelicobacter pylori infection in childhood: result of management with raniticline bismuth citrate plus amoxicillin and tinidazole J.Gastroenterol.Hepatol. 2000 ; 15(11) : 1243-50
- Xiao,S.D.; Liu,W.Z. Hu,P.J.; Xia,D . .I .; and Tytgat,G.N. High cure rate of Helicobacter pylori infection using tri potassium dicitrate bismuthate, furazoliclone and clarithromycin triple therapy for 1 week Aliment. Pharmacol. Ther. 1999; 13 (3): 311-5.
- Liu,W.Z.; Xiao,S.D.; Hu,P.J.; Lu,H.; Cui,Y.; and Tytgat,G.N. A new quadruple therapy for Helicobacter
pylori infection using tripotassium dicitrate bismuthate, furazolidone, famotidine and josamycin. Aliment. Pharmacol.Ther. 2000;14 (11) : 1519-22.
- Kihira,K.; Sato,K.; Yoshida,Y. Kumakura,Y.; Kimura,K.; and Sugano.K. Triple therapy regimens involving Tb blockaders for therapy of Helicobacter pylori infection. Nippon. Ranisho.1999 ;57(1):148-52.
- Catherine, F. W.; Mattijs, E. N.; Nick,J.W.;Andre,J.P.M.;Karel,G.M.;T heo,J.M.; and Arno,W.H. Testing for Helicobacter pylori in dyspeptic patients suspected of peptic ulcer disease in primary care: cross sectional study. BMJ. 2001 ; 323 : 71-75.
- Soll,A.H. Medical treatment of peptic ulcer disease:practice guideline . JAMA 1996; 275: 622 -629.
- Brunton,L.L. Gastrointestinal tract :management of peptic ulcer . In the pharmacological basis and therapeutics ,edited by Joel. J. Hardman, Lee. E. Linbird ,Prery. B. Molinoff ,Rayman. W.Raddon and Alfred Goodman Gilman. McGraw-Hill ,New-York ,9th ed. USA 1996 pp 901-915.
- Murakami,K.; and Kimoto,M. Antibiotic-resistance H.pylori strain in the last ten years 111 Japan. Nippon.Rinsho. 1999; 57(1): 81-6.
- Sekine,H. Ohara,S.; Iijima,K.; and Kato,K. Recurrence rate of H.pylori after ·successful eradication and second eradication therapy after initial failure of treatment . Nippon.Rinsho. 1999 ; 57(1): 116-20.
- Hus,P.I. ,Lai,K.H.; Tseng, H. H.; Lo, G. H.; Lo,C.C.; and Liu,C.K. Eradication of Helicobacter pylori prevent ulcer development in patient with ulcer like functional dyspepsia . Aliment. Pharmacol. Ther. 2001; 15(2) :195-201.
Murakami,K.;Satoh,R.; Okimoto, T. ;Kagawa,J.; Fujioka, T. ;and Kodama, M.Selection of antibiotic and planning of eradication for H. pylori infection .Nippon. Rinsho. 2001 ; 5(2):308-313 .
- Ormand,J.E.; and Talley,N.J. Helicobacter pylori :Controversies and an approach to management . Mayo Clin. Proc. 1990;65:414-26.
- Rauws, E. A.; Langenberg, W.; Houthoff, H. J.; Zanen, H. C.; and Tygat, G. N. Compylobacter pyloridi - associated chronic active antral gastritis. A prospective study of its prevalence and the effects of antibacterial and anti-ulcer treatment . Gastroenterol. 1988 ; 94 :33-40 .
- Marashall, B.; and Warren, J. R. Unidentified curved bacilli on gastric epithelium in active chronic gastritis . Lancent 1983 ; 1: 1273-5.
- Kodama, M.; and Fujioka, T. Eradication therapy of Helicobacter pylori infection. Rinsho. Byori. 2001 92 (2): 130-4.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal, and all journal content is available for readers free of charge immediately upon publication.
