High-dose esomeprazole and amoxicillin dual therapy for first-line Helicobacter pylori eradication: a proof of concept study

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High-dose esomeprazole and amoxicillin dual therapy for first-line Helicobacter pylori eradication: a proof of concept study (EN)

Manes, Gianpiero
Alvaro, Domenico
De Francesco, Vincenzo
Ridola, Lorenzo
Zullo, Angelo; Nuovo Regina Margherita Hospital
Bellesia, Annamaria
de Nucci, Germana
Gatta, Luigi
Hassan, Cesare

Background The prevalence of resistance to clarithromycin and metronidazole has considerably increased, with a corresponding decrease in the eradication rate for Helicobacter pylori (H. pylori) infection. Primary resistance to amoxicillin is extremely low, and esomeprazole was found to exert a noteworthy antimicrobial activity in vitro against H. pylori. A dual therapy with high-dose of esomeprazole coupled with high-dose amoxicillin might be therefore an ideal first-line treatment for H. pylori eradication. We aimed to assess the efficacy of a first-line 10-day, high-dose dual therapy consisting of amoxicillin and esomeprazole to eradicate H. pylori infection.Methods Consecutive naïve H. pylori-infected patients, who underwent an upper endoscopy in 4 Italian hospitals due to dyspeptic symptoms and found to be infected at routine histological assessment, were invited to participate. Patients enrolled received a 10-day, high-dose dual therapy comprising esomeprazole (40 mg t.i.d) and amoxicillin (1 g t.i.d.). At least 4 weeks after the end of the treatment a 13C-urea breath test was performed to evaluate the eradication.Results A total of 56 patients agreed to participate in the study and were all followed-up. The overall eradication was 87.5% (95% CI=78.8•96.2), without a statistically significant difference among centres. Overall, 5 (8.9%; 1.5•16.4%) patients complained of side-effects.Conclusions Th e 10-day, high-dose dual therapy with esomeprazole and amoxicillin might be an effective and safe fi rst-line regimen. Th e effi cacy of a longer 14-day regimen should be tested.Keywords Helicobacter pylori infection, dual therapy, esomeprazole, amoxicillinAnn Gastroenterol 2015; 28 (4): 448-451 (EN)

Ελληνική Γαστροεντερολογική Εταιρία (EL)
Hellenic Gastroenterologiki Company (EN)

2015-10-01


Annals of Gastroenterology (EN)

Annals of Gastroenterology; Volume 28, No 4 (2015); 448 (EN)



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