Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.


Subscribe or Register

Existing user? Login

Triple H pylori eradication therapy for two weeks more effective than shorter four-drug regimens

By News team

Triple-drug therapy for two weeks is more effective than shorter, four-drug regimens at treating Helicobacter pylori infection, new data suggest (Lancet online, 20 July 2011).

Contrary to previous findings in European populations (PJ, 26 February 2011, p220), the Latin-American study showed eradication of H pylori was more likely with 14 days of the standard regimen of clarithromycin, amoxicillin and a proton-pump inhibitor (lansoprazole) than with a five- or 10-day regimen that also included metronidazole (see Panel).

The authors say that geographical variations in H pylori’s resistance to antibiotics might account for some of the discrepancies between their results and those of studies carried out elsewhere. Different eradication regimens will be suitable in different regions, they suggest.

They also propose that population-wide H pylori eradication programmes based on the triple-drug regimen should be undertaken in Latin America as a means of reducing the region’s high rates of gastric cancer.

However, an accompanying comment advises against this approach, highlighting risks including anaphylactic reactions, Clostridium difficile infection and the development of antibiotic resistance.

Study details

Over 14,000 adults with Helicobacter pylori infection were randomly allocated to twice-daily treatment with either: Lansoprazole 30mg, amoxicillin 1,000mg and clarithromycin 500mg for 14 days (n=488); Lansoprazole 30mg, amoxicillin 1,000mg and clarithromycin 500mg and metronidazole 500mg for five days (n=489); or lansoprazole 30mg and amoxicillin 1,000mg for five days followed by lansoprazole 30mg, clarithromycin 500mg and metronidazole 500mg for five days (n=486).

In intention-to-treat analyses, standard triple-drug therapy was associated with an 82.2 per cent probability of H pylori eradication — 8.6 percentage points higher than the five-day quadruple-drug regimen (73.6 per cent, 95 per cent adjusted confidence interval 2.6–14.5) and 5.6 percentage points higher than the ten-day regimen (76.5 per cent, CI -0.4–11.6).

Although the 5.6 percentage point difference was not significant (P=0.04; significance at P values less than 0.025), the near significance suggests the ten-day quadruple-drug regimen is less effective than triple-drug therapy, the authors say.

Citation: The Pharmaceutical Journal URI: 11080907

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Injectable Drugs Guide

    Injectable Drugs Guide

    A user friendly, single point of reference for healthcare professionals in the safe and effective administration of injectable medicines.

    £54.00Buy now
  • Good Pharmacovigilance Practice Guide

    Good Pharmacovigilance Practice Guide

    An essential guide on pharmacovigilance of medicinal products for human use. Practical advice for developing effective pharmacovigilance systems.

    £38.00Buy now
  • Basic Pharmacokinetics

    Basic Pharmacokinetics

    A clear and concise basic pharmacokinetics textbook. Shows how to apply the principles to achieve successful drug therapy.

    £54.00Buy now
  • Essentials of Pharmacy Management

    Essentials of Pharmacy Management

    Essentials of Pharmacy Management is an accessible introduction to management. It provides a jump-start to leadership roles and career advancement.

    £43.00Buy now
  • Drugs in Use

    Drugs in Use

    Optimise drug therapy for your patients. These case studies help you bridge the gap between theoretical medicines knowledge and practical applications.

    £43.00Buy now

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete
  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Supplementary images

  • H pylori (Medical Photo Library)

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.