Efficacy of a “Rescue” Ciprofloxacin-Based Regimen for Eradication of Helicobacter pylori Infection after Treatment Failures
The aim of our study was to evaluate the efficacy and tolerability of a ciprofloxacin-based regimen for H. pylori eradication failures as an alternative to bismuth based quadruple therapy. Methods. Design: prospective single-center study. Patients in whom a first eradication trial with omeprazole/...
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| Format: | Article |
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Wiley
2012-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2012/484591 |
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| author | Maria Pina Dore Vincenza Tadeu Bianca Are Ida Mura Giuseppe Fanciulli Giovannino Massarelli Andrea Piana |
| author_facet | Maria Pina Dore Vincenza Tadeu Bianca Are Ida Mura Giuseppe Fanciulli Giovannino Massarelli Andrea Piana |
| author_sort | Maria Pina Dore |
| collection | DOAJ |
| description | The aim of our study was to evaluate the efficacy and tolerability of a ciprofloxacin-based regimen for H. pylori eradication failures as an alternative to bismuth based quadruple therapy. Methods. Design: prospective single-center study. Patients in whom a first eradication trial with omeprazole/esomeprazole, clarithromycin plus amoxicillin or tinidazole/metronidazole had failed were included. H. pylori status: established by histology, rapide urease test and polymerase chain reaction. Intervention: esomeprazole 20 mg, ciprofloxacin 500 mg, and metronidazole 500 mg, administered together before breakfast and dinner for 10 days. Susceptibility testing was performed by the Epsilometer test. Ciprofloxacin resistance was defined as a MIC of ≥1 μg/mL. Eradication was established by a negative 13C-UBT and 4–6 weeks post-therapy. Efficacy and side effects were determined. Results. 34 patients were enrolled, 32 completed the study. Compliance was excellent (100%). Side effects were mild. Ciprofloxacin-based therapy cured 65% (22/34) of patients by intention to treat and 69% (22/32) per protocol analysis. The prevalence of ciprofloxacin resistance was 8%. Conclusions. The effectiveness of ciprofloxacin-based therapy was greatly reduced despite the high prevalence of ciprofloxacin sensitive H. pylori strains. Bismuth based quadruple therapy still remain the best choice as a “rescue” regimen in our region. |
| format | Article |
| id | doaj-art-7deb4d5a2fd2428fa9dad7e3d8278714 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-7deb4d5a2fd2428fa9dad7e3d82787142025-02-03T05:48:10ZengWileyGastroenterology Research and Practice1687-61211687-630X2012-01-01201210.1155/2012/484591484591Efficacy of a “Rescue” Ciprofloxacin-Based Regimen for Eradication of Helicobacter pylori Infection after Treatment FailuresMaria Pina Dore0Vincenza Tadeu1Bianca Are2Ida Mura3Giuseppe Fanciulli4Giovannino Massarelli5Andrea Piana6Clinica Medica, Dipartimento di Medicina Clinica e Sperimentale, Università di Sassari, Viale San Pietro, 8, 07100 Sassari, ItalyClinica Medica, Dipartimento di Medicina Clinica e Sperimentale, Università di Sassari, Viale San Pietro, 8, 07100 Sassari, ItalySezione di Igiene, Dipartimento di Scienze Biomediche, Università di Sassari, Via Padre Manzella 4, 07100 Sassari, ItalySezione di Igiene, Dipartimento di Scienze Biomediche, Università di Sassari, Via Padre Manzella 4, 07100 Sassari, ItalyClinica Medica, Dipartimento di Medicina Clinica e Sperimentale, Università di Sassari, Viale San Pietro, 8, 07100 Sassari, ItalyClinica Medica, Dipartimento di Medicina Clinica e Sperimentale, Università di Sassari, Viale San Pietro, 8, 07100 Sassari, ItalySezione di Igiene, Dipartimento di Scienze Biomediche, Università di Sassari, Via Padre Manzella 4, 07100 Sassari, ItalyThe aim of our study was to evaluate the efficacy and tolerability of a ciprofloxacin-based regimen for H. pylori eradication failures as an alternative to bismuth based quadruple therapy. Methods. Design: prospective single-center study. Patients in whom a first eradication trial with omeprazole/esomeprazole, clarithromycin plus amoxicillin or tinidazole/metronidazole had failed were included. H. pylori status: established by histology, rapide urease test and polymerase chain reaction. Intervention: esomeprazole 20 mg, ciprofloxacin 500 mg, and metronidazole 500 mg, administered together before breakfast and dinner for 10 days. Susceptibility testing was performed by the Epsilometer test. Ciprofloxacin resistance was defined as a MIC of ≥1 μg/mL. Eradication was established by a negative 13C-UBT and 4–6 weeks post-therapy. Efficacy and side effects were determined. Results. 34 patients were enrolled, 32 completed the study. Compliance was excellent (100%). Side effects were mild. Ciprofloxacin-based therapy cured 65% (22/34) of patients by intention to treat and 69% (22/32) per protocol analysis. The prevalence of ciprofloxacin resistance was 8%. Conclusions. The effectiveness of ciprofloxacin-based therapy was greatly reduced despite the high prevalence of ciprofloxacin sensitive H. pylori strains. Bismuth based quadruple therapy still remain the best choice as a “rescue” regimen in our region.http://dx.doi.org/10.1155/2012/484591 |
| spellingShingle | Maria Pina Dore Vincenza Tadeu Bianca Are Ida Mura Giuseppe Fanciulli Giovannino Massarelli Andrea Piana Efficacy of a “Rescue” Ciprofloxacin-Based Regimen for Eradication of Helicobacter pylori Infection after Treatment Failures Gastroenterology Research and Practice |
| title | Efficacy of a “Rescue” Ciprofloxacin-Based Regimen for Eradication of Helicobacter pylori Infection after Treatment Failures |
| title_full | Efficacy of a “Rescue” Ciprofloxacin-Based Regimen for Eradication of Helicobacter pylori Infection after Treatment Failures |
| title_fullStr | Efficacy of a “Rescue” Ciprofloxacin-Based Regimen for Eradication of Helicobacter pylori Infection after Treatment Failures |
| title_full_unstemmed | Efficacy of a “Rescue” Ciprofloxacin-Based Regimen for Eradication of Helicobacter pylori Infection after Treatment Failures |
| title_short | Efficacy of a “Rescue” Ciprofloxacin-Based Regimen for Eradication of Helicobacter pylori Infection after Treatment Failures |
| title_sort | efficacy of a rescue ciprofloxacin based regimen for eradication of helicobacter pylori infection after treatment failures |
| url | http://dx.doi.org/10.1155/2012/484591 |
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