Skip to main content
SpringerLink
Log in

Treatment of Helicobacter pylori Infection in Clinical Practice in the United States

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Our objectives were to define treatment success, compliance, and side effects for treatment of Helicobacter pylori in clinical practice. In all, 224 consecutive patients received Helicobacter pylori treatment: 97 received two weeks of bismuth subsalicylate, metronidazole, tetracycline four times a day with a H2-receptor antagonist twice a day (BMT); 89 received one week of metronidazole, lansoprazole, and clarithromycin twice a day (MLC); and 38 received one week of BMT with lansoprazole twice a day (BMT-PPI). Cure rates were: BMT 81% (95% CI 74–89%), MLC 90% (95% CI 84–96%) BMT-PPI 87% (95% CI 81–92%). More patients prescribed a bismuth-based regimen discontinued medications due to side effects compared to MLC (P = 0.049). Nausea was more common for BMT compared to MLC (P = 0.04). In conclusion, treatment of Helicobacter pylori infection with a one-week course of MLC achieves a high rate of cure in clinical practice. Significantly fewer patients prescribed PPI-based therapy discontinue medications due to side effects as compared to bismuth-based triple therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. van der Hulst RWM, Keller JJ, Rauws EAJ, Tytgat GNJ: Treatment of Helicobacter pylori infection: A review of the world literature. Helicobacter 1:6-19, 1996

    Google Scholar 

  2. Fennerty MB: Should we abandon metronidazole contaiinng Helicobacter pylori treatment regimens? The clinical relevance of metronidazole resistance. Am J Gastroenterol 93:2-3, 1998

    Google Scholar 

  3. Midolo PD, Lambert JR, Turnidge J: Metronidazole resistance: A predictor of failure of Helicobacter pylori eradication by triple therapy. J Gastroenterol Hepatol 11:290-292, 1996

    Google Scholar 

  4. Penston JG: Helicobacter pylori eradication-understandable caution but no excuse for inertia. Aliment Pharmacol Ther 8:369-389, 1994

    Google Scholar 

  5. Tytgat GNJ: Treatments that impact favourably upon the eradication of Helicobacter pylori and ulcer recurrence. Aliment Pharmacol Ther 8:359-368, 1994

    Google Scholar 

  6. Fennerty MB, Lieberman DL, Magaret N, Consortium AG: Effectiveness of H. pylori treatment regimens in clinical practice: A community-based outcomes study. Gastroenterology 112:A14, 1997

    Google Scholar 

  7. Walsh JH, Peterson WL: The treatment of Helicobacter pylori infection in the management of peptic ulcer disease. N Engl J Med 333:984-991, 1995

    Google Scholar 

  8. Current European concepts in the management of Helicobacter pylori infection. The Maastricht Consensus Report. Gut 41:8-13, 1997

  9. Unge P: What other regimens are under investigation to treat Helicobacter pylori infection? Gastroenterology 113:S131-S148, 1997

    Google Scholar 

  10. Yang R, Hamamoto R, Laine L: 1-Week vs 2-week bismuth subsalicylate-based triple therapy for H. pylori: Results of a US randomized trial. Gastroenterology 114:A340, 1998

    Google Scholar 

  11. Goddard AF, Spiller RC: One-week low-dose triple therapy is preferable to classical bismuth based triple therapy. Aliment Pharmacol Ther 10:1009-1013, 1996

    Google Scholar 

  12. Lerang F, Moum B, Ragnhildstveit E, Sandvei PK, Tolas P, Whist JE, Henriksen M, Haug JB, Berge T: Simplified 10-day bismuth triple therapy for cure of Helicobacter pylori infection: Experience from clinical practice in a population with a high frequency of metronidazole resistance. Am J Gastroenterol 93:212-216, 1998

    Google Scholar 

  13. Reilly TG, Ayres RC, Poxon V, Walt RP: Helicobacter pylori eradication in a clinical setting: Success rates and the effect on the quality of life in peptic ulcer. Aliment Pharmacol Ther 9:483-490, 1995

    Google Scholar 

  14. American Gastroenterological Association Medical Position Statement: Evaluation of dyspepsia. Gastroenterology 114:579-581, 1998

    Google Scholar 

  15. NIH Consensus Conference: Helicobacter pylori in peptic ulcer disease. JAMA 272:65-69, 1994

    Google Scholar 

  16. Evans DJ, Evans DG, Graham DY, Klein PD: A sensitive and specific serologic test for detection of Campylobacter pylori infection. Gastroenterology 96:1004-1008, 1989

    Google Scholar 

  17. Marchildon PA, Ciota LM, Zamaniyan FZ, Peacock JS, Graham DY: Evaluation of three commercial enzyme immunoassays compared with the 13C urea breath test for detection of Helicobacter pylori infection. J Clin Microbiol 34:1147-1152, 1996

    Google Scholar 

  18. Talley NJ, Kost L, Haddad A, Zinsmeister AR: Comparison of commercial serological tests for detection of Helicobacter pylori antibodies. J Clin Microbiol 30:3146-3150, 1992

    Google Scholar 

  19. Talley NJ, Newell DG, Ormand JE, Carpenter HA, Wilson WR, Zinsmeister AR, Perez-Perez GI, Blaser MJ: Serodiagnosis of Helicobacter pylori: Comparison of enzyme-linked immunosorbent assays. J Clin Microbiol 29:1635-1639, 1991

    Google Scholar 

  20. Wilcox MH, Dent THS, Hunter JO, Gray JJ, Brown DFJ, Wight DGD, Wraight EP: Accuracy of serology for the diagnosis of Helicobacter pylori infection-a comparison of eight kits. J Clin Pathol 49:373-376, 1996

    Google Scholar 

  21. Dalla Libera M, Pazzi P, Carli G, Gamberini S, Scagliarini R, Merighi A, Gullini S: High effectiveness and safety of one-week antibiotic regimen in Helicobacter pylori eradication. Aliment Pharmacol Ther 10:203-206, 1996

    Google Scholar 

  22. Laine L, Frantz JE, Baker A, Neil GA: A United States multicentre trial of dual and proton pump inhibitor-based triple therapies for Helicobacter pylori. Aliment Pharmacol Ther 11:913-917, 1997

    Google Scholar 

  23. Yousfi MM, El-Zimaity HMT, Al-Assi MT, Cole RA, Genta RM, Graham DY: Metronidazole, omeprazole and clarithromycin: an effective combination therapy for Helicobacter pylori infection. Aliment Pharmacol Ther 9:209-212, 1995

    Google Scholar 

  24. de Boer W, Driessen W, Jansz A, Tytgat G: Effect of acid suppression on efficacy of treatment for Helicobacter pylori infection. Lancet 345:817-820, 1995

    Google Scholar 

  25. Borody TJ, Andrews P, Fracchia G, Brandl S, Shortis NP, Bae H: Omeprazole enhances efficacy of triple therapy in eradicating Helicobacter pylori. Gut 37:477-481, 1995

    Google Scholar 

  26. de Boer WA, van Etten RJ, Lai JY, Schneeberger PM, van de Wouw BA, Driessen WM: Effectiveness of quadruple therapy using lansoprazole, instead of omeprazole, in curing Helicobacter pylori infection. Helicobacter 1:145-150, 1996

    Google Scholar 

  27. Hosking SW, Ling TKW, Yung MY, et al: Randomised controlled trial of short term treatment to eradicate H. pylori in patients with duodenal ulcer. Br Med J 305:502-504, 1992

    Google Scholar 

  28. Vautier G, Scott BB: A one-week quadruple eradication regimen for Helicobacter pylori in routine clinical practice. Aliment Pharmacol Ther 11:107-108, 1997

    Google Scholar 

  29. de Boer WA, van Etten RJ, Schneeberger PM: Four-day lansoprazole-quadruple therapy in the routine treatment of Helicobacter pylori infection. Neth J Med 52:10-15, 1998

    Google Scholar 

  30. Lind T, Veldhuyzen van Zanten S, Unge P, Spiller R, Bayerdorffer E, O'Morain C, Bardhan KD, Bradette M, Chiba N, Wrangstadh M, Cederberg C, Idstrom JP: Eradication of Helicobacter pylori using one-week triple therapies combining omeprazole with two antimicrobials: The MACH 1 study. Helicobacter 1:138-144, 1996

    Google Scholar 

  31. Misiewicz JJ, Harris AW, Bardhan KD, Levi S, O'Morain C, Cooper BT, Kerr GD, Dixon MF, Langworthy H, Piper D: One week triple therapy for Helicobacter pylori: A multicentre comparative study. Lansoprazole Helicobacter study group. Gut 41:735-739, 1997

    Google Scholar 

  32. Lind T, Megraud F, Unge P, Bayerdorffer E, O'Morain C, Spiller R, Veldhuyzen Van Zanten S, Dev Bardhan K, Hellblom M, Wrangstadh M, Zeijlon L, Cederberg C: The MACH2 study: Role of omeprazole in eradication of Helicobacter pylori with 1-week triple therapies. Gastroenterology 116:248-253, 1999

    Google Scholar 

  33. Jaup BH, Norrby A: Comparison of two low-dose one-week triple therapy regimens with and without metronidazole for cure of H. pylori infection. Aliment Pharmacol Ther 10:275-277, 1996

    Google Scholar 

  34. Labenz J, Idstrom JP, Tillenburg B, Peitz U, Adamek RJ, Borsch G: One-week low-dose triple therapy for Helicobacter pylori is sufficient for relief from symptoms and healing of duodenal ulcers. Aliment Pharmacol Ther 11:89-93, 1997

    Google Scholar 

  35. O'Connor HJ, McLoughlin R, Kelly S, Laundon J, Cunnane K: Lansoprazole triple therapy for Helicobacter pylori-is 5 days enough? Aliment Pharmacol Ther 12:273-276, 1998

    Google Scholar 

  36. Schwartz H, Krause R, Siepman N, Haber M, Weissfeld A, Kidd S, Rose P, Sahba B: Seven-day triple therapy with lansoprazole, clarithromycin, and metronidazole for the cure of Helicobacter pylori infection: A short report. Helicobacter 1:251-255, 1996

    Google Scholar 

  37. Laine L, Estrada R, Trujillo M, Fukanaga K, Neil G: Randomized comparison of differing periods of twice-a-day triple therapy for the eradication of Helicobacter pylori. Aliment Pharmacol Ther 10:1029-1033, 1996

    Google Scholar 

  38. Fennerty MB, Kovacs TO, Krause R, Haber M, Weissfeld A, Siepman N, Rose P: A comparison of 10 and 14 days of lansoprazole triple therapy for eradication of Helicobacter pylori. Arch Intern Med 158:1651-1656, 1998

    Google Scholar 

  39. Dal Bo N, Di Mario F, Battaglia G, Buda A, Leandro G, Vianello F, Kusstatscher S, Salandin S, Pilotto A, Cassaro M, Vigneri S, Rugge M: Low dose of clarithromycin in triple therapy for the eradication of Helicobacter pylori: One or two weeks? J Gastroenterol Hepatol 13:288-293, 1998

    Google Scholar 

  40. Moayyedi P, Langworthy H, Shanahan K, Tompkins DS, Dixon MF, Chalmers DM, Axon AT: Comparison of one or two weeks of lansoprazole, amoxicillin, and clarithromycin in the treatment of Helicobacter pylori. Helicobacter 1:71-74, 1996

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. VA Puget Sound Health Care System, University of Washington, Seattle, Washington

    David J. Kearney & Andrea Brousal

Authors
  1. David J. Kearney
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea Brousal
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kearney, D.J., Brousal, A. Treatment of Helicobacter pylori Infection in Clinical Practice in the United States. Dig Dis Sci 45, 265–271 (2000). https://doi.org/10.1023/A:1005444006042

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1005444006042

Search

Navigation