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A 2-week Nitazoxanide-based quadruple treatment as a rescue therapy for Helicobacter pylori eradication

View Article: PubMed Central - PubMed

ABSTRACT

As there are increasing reports of fluoroquinolone resistance on use as a first- or second-line treatment for Helicobacter pylori (H pylori), we aimed at evaluation of the efficacy and safety of nitazoxanide-based regimen as a rescue regimen in Egyptian patients whose previous traditional treatment for H pylori infection failed.In total, 100 patients from the outpatient clinic of the Tropical medicine department, Tanta University hospital in whom the standard triple therapy (clarithromycin-based triple therapy) failed were enrolled in the study. Nitazoxanide (500 mg bid), levofloxacin (500 mg once daily), omeprazole (40 mg bid), and doxycyclin (100 mg twice daily) were prescribed for 14 days. Eradication was confirmed by stool antigen for H pylori 6 weeks after the end of treatment. Among the patients enrolled in the study, 44% of patients were men and the mean age for the participants in the study was 46.41 ± 8.05, 13% of patients were smokers, and 4% of patients had a previous history of upper gastro-intestinal bleeding. A total of 94 patients (94%) completed the study with excellent compliance. Only 1 patient (1%) discontinued treatment due to intolerable side effects and 5 patients (5%) did not achieve good compliance or were lost during follow up. However, 83 patients had successful eradication of H pylori with total eradication rates 83% (95 % CI 75.7–90.3%) and 88.30% (95 % CI 81.8–94.8%) according to an intention-to-treat and per-protocol analysis, respectively. Adverse events were reported in 21% of patients: abdominal pain (6%), nausea (9%) and constipation (12%), (2%) headache, and (1%) dizziness. A 2-week nitazoxanide-based regimen is an effective and safe rescue therapy in Egyptian patients whose previous standard triple therapy has failed.

No MeSH data available.


Flow diagram of quadruple therapy.
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Figure 1: Flow diagram of quadruple therapy.

Mentions: A 370 patients infected with H pylori received the standard triple therapy. Eradication was successful in only 223 patients (60.27%) raising questions if H pylori is still responding to standard triple therapy. Then eradication-failure patients (147 patients) were invited and assessed for participation in the study. However, 47 patients were excluded from the study (21 were not meeting inclusion and exclusion criteria and 26 declined or refused to participate in the study). Finally, a total of 100 patients with persistent H pylori infection were enrolled in this study (the flow diagram of the study is shown in Fig. 1).


A 2-week Nitazoxanide-based quadruple treatment as a rescue therapy for Helicobacter pylori eradication
Flow diagram of quadruple therapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998463&req=5

Figure 1: Flow diagram of quadruple therapy.
Mentions: A 370 patients infected with H pylori received the standard triple therapy. Eradication was successful in only 223 patients (60.27%) raising questions if H pylori is still responding to standard triple therapy. Then eradication-failure patients (147 patients) were invited and assessed for participation in the study. However, 47 patients were excluded from the study (21 were not meeting inclusion and exclusion criteria and 26 declined or refused to participate in the study). Finally, a total of 100 patients with persistent H pylori infection were enrolled in this study (the flow diagram of the study is shown in Fig. 1).

View Article: PubMed Central - PubMed

ABSTRACT

As there are increasing reports of fluoroquinolone resistance on use as a first- or second-line treatment for Helicobacter pylori (H pylori), we aimed at evaluation of the efficacy and safety of nitazoxanide-based regimen as a rescue regimen in Egyptian patients whose previous traditional treatment for H pylori infection failed.In total, 100 patients from the outpatient clinic of the Tropical medicine department, Tanta University hospital in whom the standard triple therapy (clarithromycin-based triple therapy) failed were enrolled in the study. Nitazoxanide (500 mg bid), levofloxacin (500 mg once daily), omeprazole (40 mg bid), and doxycyclin (100 mg twice daily) were prescribed for 14 days. Eradication was confirmed by stool antigen for H pylori 6 weeks after the end of treatment. Among the patients enrolled in the study, 44% of patients were men and the mean age for the participants in the study was 46.41 ± 8.05, 13% of patients were smokers, and 4% of patients had a previous history of upper gastro-intestinal bleeding. A total of 94 patients (94%) completed the study with excellent compliance. Only 1 patient (1%) discontinued treatment due to intolerable side effects and 5 patients (5%) did not achieve good compliance or were lost during follow up. However, 83 patients had successful eradication of H pylori with total eradication rates 83% (95 % CI 75.7–90.3%) and 88.30% (95 % CI 81.8–94.8%) according to an intention-to-treat and per-protocol analysis, respectively. Adverse events were reported in 21% of patients: abdominal pain (6%), nausea (9%) and constipation (12%), (2%) headache, and (1%) dizziness. A 2-week nitazoxanide-based regimen is an effective and safe rescue therapy in Egyptian patients whose previous standard triple therapy has failed.

No MeSH data available.