Quadruple Therapy for Triple Therapy Resistant Helicobacter Pylori Infection (QT-Hp)
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Purpose
Triple therapy, a combination of proton pump inhibitor with two antibiotics, is the gold standard for anti-Helicobacter pylori treatment. Usual antibiotics are clarithromycin, and either amoxicillin or one of the nitroimidazoles (metronidazole). However, there is an increasing evidence of H. pylori resistance to classical triple therapy. Another reason for this failure being low patient compliance with treatment. A regimen useful in one geographical area may not be effective or practical in another area. The aim of this study was to eradicate H. pylori infection resistant to triple therapy, establish the efficacy and safety of a 14-day therapeutic regimen to eradicate of H. pylori in patients who have failed with the classical triple therapy (omeprazole, clarithromycin and amoxicillin) given for 14 days.
| Condition | Intervention |
|---|---|
|
Treatment of Helicobacter Pylori |
Drug: Augmentin (Amoxicillin-clavulanic) Drug: Furoxone (furazolidone) Drug: Cebes (colloidal bismuth subcitrate) Drug: Esso (esomeprazole) |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Quadruple Therapy Using Esomeprazole, Colloidal Bismuth Subcitrate, Amoxicillin-Clavulanate, and Furazolidone in Patients Who Failed to Eradicate H. Pylori With Triple Therapy |
- Eradication of H. pylori infection resistant to triple therapy. [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
- Safety of the quadruple therapy [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
| Enrollment: | 176 |
| Study Start Date: | October 2006 |
| Study Completion Date: | June 2008 |
| Primary Completion Date: | June 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Quadruple Therapy |
Drug: Augmentin (Amoxicillin-clavulanic)
Amoxicillin-clavulanic acid 1 gram b.i.d
Drug: Furoxone (furazolidone)
furazolidone 200 mg b.i.d
Drug: Cebes (colloidal bismuth subcitrate)
colloidal bismuth subcitrate 240 mg b.i.d
Drug: Esso (esomeprazole)
esomeprazole 40 mg b.i.d for 14 days
|
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Informed consent given by the patient
- Patients known to have H. pylori infection diagnosed by histopathology, rapid urease test and urea breath test
- Failure to respond to classical triple regime of amoxicillin 1gram, clarithromycin 500mg and omeprazole 20mg twice a day for 10-14 days as documented by repeat urea breath test done one month after eradication therapy
Exclusion Criteria:
- Evidence of any malignancy, gastric outlet syndrome, history of gastric surgery, chronic liver disease, severe chronic renal failure, or any major co-morbidity.
- known or suspected hypersensitivity to the medication used in the study
Contacts and Locations
More Information
No publications provided by Aga Khan University
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Dr Zaigham Abbas, The Aga Khan University Hospital |
| ClinicalTrials.gov Identifier: | NCT00520949 History of Changes |
| Other Study ID Numbers: | 609-Med |
| Study First Received: | August 24, 2007 |
| Last Updated: | April 7, 2009 |
| Health Authority: | Pakistan: Research Ethics Committee |
Keywords provided by Aga Khan University:
|
H.pylori Triple therapy failure Quadruple therapy |
Additional relevant MeSH terms:
|
Amoxicillin Amoxicillin-Potassium Clavulanate Combination Bismuth tripotassium dicitrate Furazolidone Bismuth Omeprazole Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Antacids |
Molecular Mechanisms of Pharmacological Action Anti-Infective Agents, Local Anti-Infective Agents, Urinary Renal Agents Antitrichomonal Agents Antiprotozoal Agents Antiparasitic Agents Monoamine Oxidase Inhibitors Enzyme Inhibitors Anti-Ulcer Agents Gastrointestinal Agents |
ClinicalTrials.gov processed this record on May 23, 2013