14-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial

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dc.contributor.authorGreenberg, E. Robert
dc.contributor.authorAnderson, Garnet L.
dc.contributor.authorMorgan, Douglas R.
dc.contributor.authorTorres, Javier
dc.contributor.authorChey, William D.
dc.contributor.authorEduardo Bravo, Luis
dc.contributor.authorDominguez, Ricardo L.
dc.contributor.authorFerreccio, Catterina
dc.contributor.authorHerrero, Rolando
dc.contributor.authorLazcano Ponce, Eduardo C.
dc.contributor.authorMercedes Meza Montenegro, Maria
dc.contributor.authorPena, Rodolfo
dc.contributor.authorPena, Edgar M.
dc.contributor.authorSalazar Martinez, Eduardo
dc.contributor.authorCorrea, Pelayo
dc.contributor.authorElena Martinez, Maria
dc.contributor.authorValdivieso, Manuel
dc.contributor.authorGoodman, Gary E.
dc.contributor.authorCrowley, John J.
dc.contributor.authorBaker, Laurence H.
dc.date.accessioned2024-01-10T12:37:21Z
dc.date.available2024-01-10T12:37:21Z
dc.date.issued2011
dc.description.abstractBackground Evidence from Europe, Asia, and North America suggests that standard three-drug regimens of a proton-pump inhibitor plus amoxicillin and clarithromycin are significantly less effective for eradication of Helicobacter pylori infection than are 5-day concomitant and 10-day sequential four-drug regimens that include a nitroimidazole. These four-drug regimens also entail fewer antibiotic doses than do three-drug regimens and thus could be suitable for eradication programmes in low-resource settings. Few studies in Latin America have been done, where the burden of H pylori-associated diseases is high. We therefore did a randomised trial in Latin America comparing the effectiveness of four-drug regimens given concomitantly or sequentially with that of a standard 14-day regimen of triple therapy.
dc.description.abstractMethods Between September, 2009, and June, 2010, we did a randomised trial of empiric 14-day triple, 5-day concomitant, and 10-day sequential therapies for H pylori in seven Latin American sites: Chile, Colombia, Costa Rica, Honduras, Nicaragua, and Mexico (two sites). Participants aged 21-65 years who tested positive for H pylori by a urea breath test were randomly assigned by a central computer using a dynamic balancing procedure to: 14 days of lansoprazole, amoxicillin, and clarithromycin (standard therapy); 5 days of lansoprazole, amoxicillin, clarithromycin, and metronidazole (concomitant therapy); or 5 days of lansoprazole and amoxicillin followed by 5 days of lansoprazole, clarithromycin, and metronidazole (sequential therapy). Eradication was assessed by urea breath test 6-8 weeks after randomisation. The trial was not masked. Our primary outcome was probablity of H pylori eradication. Our analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, registration number NCT01061437.
dc.description.abstractFindings 1463 participants aged 21-65 years were randomly allocated a treatment: 488 were treated with 14-day standard therapy, 489 with 5-day concomitant therapy, and 486 with 10-day sequential therapy. The probability of eradication with standard therapy was 82.2% (401 of 488), which was 8.6% higher (95% adjusted CI 2.6-14.5) than with concomitant therapy (73.6% [360 of 489]) and 5.6% higher (-0.04% to 11.6) than with sequential therapy (76.5% [372 of 486]). Neither four-drug regimen was significantly better than standard triple therapy in any of the seven sites.
dc.description.abstractInterpretation Standard 14-day triple-drug therapy is preferable to 5-day concomitant or 10-day sequential four-drug regimens as empiric therapy for H pylori infection in diverse Latin American populations.
dc.description.funderBill & Melinda Gates Foundation
dc.description.funderUS National Institutes of Health
dc.description.funderAxcan
dc.description.funderAstraZeneca
dc.description.funderNational Institutes of Health
dc.description.funderNATIONAL CANCER INSTITUTE
dc.fechaingreso.objetodigital16-04-2024
dc.format.extent8 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1016/S0140-6736(11)60825-8
dc.identifier.issn0140-6736
dc.identifier.pubmedidMEDLINE:21777974
dc.identifier.urihttps://doi.org/10.1016/S0140-6736(11)60825-8
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/76823
dc.identifier.wosidWOS:000294077200030
dc.information.autorucMedicina;Ferreccio C ;S/I;99684
dc.issue.numero9790
dc.language.isoen
dc.nota.accesoContenido parcial
dc.pagina.final514
dc.pagina.inicio507
dc.publisherELSEVIER SCIENCE INC
dc.revistaLancet
dc.rightsacceso restringido
dc.subjectGASTRIC-CANCER
dc.subjectANTIBIOTIC-RESISTANCE
dc.subjectCOST-EFFECTIVENESS
dc.subjectMETAANALYSIS
dc.subjectERADICATION
dc.subjectCLARITHROMYCIN
dc.subjectPREVALENCE
dc.subjectMANAGEMENT
dc.subjectCHILDREN
dc.subjectBURDEN
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.title14-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial
dc.typeartículo
dc.volumen378
sipa.codpersvinculados99684
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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