Pantoprazole, azithromycin and tinidazole: short duration triple therapy for eradication of Helicobacter pylori infection (original) (raw)

2000, Alimentary Pharmacology and Therapeutics

Helicobacter pylori is an important cause of peptic ulcer disease and chronic gastritis and has been linked to the pathogenesis of gastric malignancy. For these reasons, anti-H. pylori regimens are being investigated with increasing frequency, with about 1500 reports being published between 1984 and 1999. 1 Many combinations of antibiotics and antisecretory drugs have been tested in an attempt to ®nd the optimal regimen. The regimen of choice should be cheap, simple, of shortduration, associated with few side-effects, and with an ef®cacy of 90% or greater. 2 The most popular strategies for producing a high rate (80±95%) of H. pylori eradication entail the use of two antibiotics given for at least 1-week. The use of antibiotics for shorter periods has been investigated infrequently, as the increased daily dose considered necessary is thought to be associated with an increase in side-effects. Currently, clarithromycin provides the backbone for several therapeutic regimens for H. pylori. Azithromycin is a potentially attractive therapeutic agent for H. pylori, given its excellent mean inhibitory concentration for this organism and long biological half-life. 5, 6 However, the available published trials utilizing azithromycin have yielded con¯icting results. 7±16 Moreover, some data suggest that pre-treating patients with proton pump inhibitors before starting the antibiotics could decrease the ef®cacy of the antimicrobial treatment. 17±20 We thus evaluated two regimens consisting of 7 days of pantoprazole in combination with azithromycin and tinidazole given for the ®rst or the last 3 days. We also assessed the frequency and severity of side-effects and compliance associated with each regimen.

Sign up for access to the world's latest research.

checkGet notified about relevant papers

checkSave papers to use in your research

checkJoin the discussion with peers

checkTrack your impact