Conclusions: Helicobacter pylori eradication after simple closure

Conclusions: Helicobacter pylori eradication after simple closure of duodenal ulcer perforation gives better result than the operation plus antisecretory non-eradication therapy for prevention of ulcer recurrence. All duodenal ulcer perforation patients should be tested for H. pylori infection, and eradication therapy is required in all infected patients. “
“Objectives:  The increasing levels of bacterial antibiotic resistance have

increased the need to evaluate the second-line treatments for Helicobacter pylori. Bismuth-based quadruple therapy is recommended as a second-line treatment, but the optimal duration of this treatment is still debatable. We prospectively analyzed the eradication rate of H. pylori according to the duration of the second-line bismuth-based

quadruple therapy. Selleck LDK378 Methods:  One hundred and ninety-nine patients who failed at H. pylori eradication were prospectively randomized to receive pantoprazole 40 mg twice daily, metronidazole 500 mg thrice daily, and bismuth subcitrate 300 mg and tetracycline 500 mg four times daily for 7 days (PBMT7) or for 14 days (PBMT14). The post-treatment H. pylori status was determined by the 13C-urea breath test. The eradication rates, drug compliance, and side effects of each group were evaluated. Results:  The intention-to-treat (ITT) eradication rates were 81.6% (95% CI 73.9–89.3%, 80/98) in the PBMT7 arm and 85.1% (95% CI 78.2–92.0%, 86/101) in the PBMT14 arm (p = .028, noninferiority test), while the per-protocol (PP) eradication rates were 89.6% (95% CI 83.2–96.0%, 78/87) and 96.2% (95% CI 92.0–100.0% 77/80) (p = .015, noninferiority test), respectively. Adenosine p38 MAPK inhibitors clinical trials The compliance was 88.8% (87/98) and 79.2% (80/101) in the PBMT7 and PBMT14 groups, respectively. (p = .066) The number of patients having severe side effects was 15.3% (15/98) and 21.8% (22/101) in the PBMT7 and PBMT14 groups, respectively, which was similar between both groups. (p = .243). Conclusions:  Although PBMT7 was not inferior to PBMT14 statistically, PBMT could not demonstrate

enough ITT/PP eradication rate. Therefore, it could be better to extend the duration of treatment for 2 weeks for the second-line treatment of H. pylori in Korea. “
“Background: Helicobacter pylori infection of the stomach is widespread among human populations and is considered to play a major role in the pathogenesis of various diseases such as peptic ulcer, adenocarcinoma, and mucosa associated lymphoid tissue (MALT) lymphoma of the stomach. To increase H. pylori eradication rate without increasing bacterial resistance, various regimens have been recommended. Commonly the association of at least two antibiotics with a proton-pump inhibitor is used. The treatment regimens for second-line therapy, suggested in studies from the western world may not be ideal in Iran. Aim:  In this study, we evaluated the safety and efficacy of a new quadruple therapy regimen and compared it with the standard second-line treatment for H. pylori eradication.

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