Article: Standard treatment for Helicobacter pylori infection is suboptimal in non-ulcer dyspepsia compared with duodenal ulcer in Chinese

File Download Links for fulltext
(May Require Subscription)
Supplementary
  • Basic View
  • Metadata View
  • XML View
TitleStandard treatment for Helicobacter pylori infection is suboptimal in non-ulcer dyspepsia compared with duodenal ulcer in Chinese
AuthorsWong, WM1
Xiao, SD2
Hu, PJ3
Wang, WH1
Gu, Q1
Huang, JQ1
Xia, HHX1
Wu, SM2
Li, CJ3
Chen, MH3
Cui, Y3
Lai, KC1
Hu, WHC1
Chan, CK1
Lam, SK1
Wong, BCY1
Issue Date2005
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
CitationAlimentary Pharmacology And Therapeutics, 2005, v. 21 n. 1, p. 73-81 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1365-2036.2004.02283.x
AbstractBackground: Recent studies suggest that the Helicobacter pylori eradication rate in patients with non-ulcer dyspepsia is lower when compared to patients with peptic ulcer diseases. Aim: The aim of this study was to study the efficacy of triple therapy for H. pylori infection in patients with duodenal ulcer vs. patients with non-ulcer dyspepsia. Methods: A total of 582 Chinese patients with proven H. pylori infection were recruited to receive: omeprazole 20 mg, amoxicillin 1000 mg and clarithromycin 500 mg all given twice daily for 7 days (OCA regime). Endoscopy with rapid urease test, histology and culture were performed before treatment. Post-treatment H. pylori status was determined by 13C-urea breath test. Metronidazole, clarithromycin and amoxicillin resistance was defined as minimum inhibitory concentration (MIC) of >8 μg/mL, >1 μg/mL and >1 μg/mL, respectively. Results: A significantly higher (intention-to-treat/per-protocol) eradication rate was found in patients with duodenal ulcer than those with non-ulcer dyspepsia (91/94% vs. 84/88% respectively, P = 0.011 and P = 0.016). Clarithromycin resistance rate was higher in patients with non-ulcer dyspepsia than those with duodenal ulcer (14% vs. 6%, P = 0.015). Clarithromycin resistance (40% vs. 5%, P < 0.001, OR 12. 95% CI: 5.7-24.3) and the diagnosis of non-ulcer dyspepsia (91% vs. 84%, P = 0.011. OR 2.0. 95% CI: 1.2-3.3) significantly affected the success of H. pylori eradication. Conclusion: Clarithromycin resistance accounts for the significantly lower and suboptimal H. pylori eradication rate of OCA regimen in Chinese patients with non-ulcer dyspepsia compared to those with duodenal ulcer.
ISSN0269-2813
2011 Impact Factor: 3.769
2011 SCImago Journal Rankings: 0.338
DOIhttp://dx.doi.org/10.1111/j.1365-2036.2004.02283.x
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorWong, WM
dc.contributor.authorXiao, SD
dc.contributor.authorHu, PJ
dc.contributor.authorWang, WH
dc.contributor.authorGu, Q
dc.contributor.authorHuang, JQ
dc.contributor.authorXia, HHX
dc.contributor.authorWu, SM
dc.contributor.authorLi, CJ
dc.contributor.authorChen, MH
dc.contributor.authorCui, Y
dc.contributor.authorLai, KC
dc.contributor.authorHu, WHC
dc.contributor.authorChan, CK
dc.contributor.authorLam, SK
dc.contributor.authorWong, BCY
dc.date.accessioned2012-09-05T05:24:24Z
dc.date.available2012-09-05T05:24:24Z
dc.date.issued2005
dc.description.abstractBackground: Recent studies suggest that the Helicobacter pylori eradication rate in patients with non-ulcer dyspepsia is lower when compared to patients with peptic ulcer diseases. Aim: The aim of this study was to study the efficacy of triple therapy for H. pylori infection in patients with duodenal ulcer vs. patients with non-ulcer dyspepsia. Methods: A total of 582 Chinese patients with proven H. pylori infection were recruited to receive: omeprazole 20 mg, amoxicillin 1000 mg and clarithromycin 500 mg all given twice daily for 7 days (OCA regime). Endoscopy with rapid urease test, histology and culture were performed before treatment. Post-treatment H. pylori status was determined by 13C-urea breath test. Metronidazole, clarithromycin and amoxicillin resistance was defined as minimum inhibitory concentration (MIC) of >8 μg/mL, >1 μg/mL and >1 μg/mL, respectively. Results: A significantly higher (intention-to-treat/per-protocol) eradication rate was found in patients with duodenal ulcer than those with non-ulcer dyspepsia (91/94% vs. 84/88% respectively, P = 0.011 and P = 0.016). Clarithromycin resistance rate was higher in patients with non-ulcer dyspepsia than those with duodenal ulcer (14% vs. 6%, P = 0.015). Clarithromycin resistance (40% vs. 5%, P < 0.001, OR 12. 95% CI: 5.7-24.3) and the diagnosis of non-ulcer dyspepsia (91% vs. 84%, P = 0.011. OR 2.0. 95% CI: 1.2-3.3) significantly affected the success of H. pylori eradication. Conclusion: Clarithromycin resistance accounts for the significantly lower and suboptimal H. pylori eradication rate of OCA regimen in Chinese patients with non-ulcer dyspepsia compared to those with duodenal ulcer.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationAlimentary Pharmacology And Therapeutics, 2005, v. 21 n. 1, p. 73-81 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1365-2036.2004.02283.x
dc.identifier.citeulike74115
dc.identifier.doihttp://dx.doi.org/10.1111/j.1365-2036.2004.02283.x
dc.identifier.epage81
dc.identifier.issn0269-2813
2011 Impact Factor: 3.769
2011 SCImago Journal Rankings: 0.338
dc.identifier.issue1
dc.identifier.pmid15644048
dc.identifier.scopuseid_2-s2.0-20244380121
dc.identifier.spage73
dc.identifier.urihttp://hdl.handle.net/10722/162851
dc.identifier.volume21
dc.languageeng
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
dc.publisher.placeUnited Kingdom
dc.relation.ispartofAlimentary Pharmacology and Therapeutics
dc.relation.referencesReferences in Scopus
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAmoxicillin - Therapeutic Use
dc.subject.meshAnti-Ulcer Agents - Therapeutic Use
dc.subject.meshAsian Continental Ancestry Group - Ethnology
dc.subject.meshClarithromycin - Therapeutic Use
dc.subject.meshDrug Resistance
dc.subject.meshDrug Therapy, Combination - Therapeutic Use
dc.subject.meshDuodenal Ulcer - Ethnology - Microbiology
dc.subject.meshDyspepsia - Ethnology - Microbiology
dc.subject.meshFemale
dc.subject.meshHelicobacter Infections - Drug Therapy - Ethnology
dc.subject.meshHelicobacter Pylori
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMetronidazole - Therapeutic Use
dc.subject.meshMiddle Aged
dc.subject.meshOmeprazole - Therapeutic Use
dc.subject.meshPatient Compliance
dc.subject.meshTreatment Outcome
dc.titleStandard treatment for Helicobacter pylori infection is suboptimal in non-ulcer dyspepsia compared with duodenal ulcer in Chinese
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong
  2. Shanghai Second Medical University
  3. Sun Yat Sen University of Medical Sciences