To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Novel 4-Drug Regimen Highly Active Against Nonresponsive Helicobacter Pylori: Presented at UEGW URL: http://www.pslgroup.com/dg/2314A6.htm Doctor's Guide October 23, 2008
By Judith Moser, MD VIENNA, Austria -- October 23, 2008 -- Helicobacter pylori infection can be eradicated with high success rates in patients who failed to respond to a previous treatment regime, according to a study presented here at the 16th United European Gastroenterology Week (UEGW). Multiple therapeutic regimens have been explored to eradicate H. pylori with variable success rates due to increasing drug resistance and virulent bacterial gene expression. In the United States, H. pylori resistance rates have been reported to be as high as 66% for metronidazole and 30% for clarithromycin, said study presenter Krishna Rayapudi, MD, Department of Gastroenterology, Hepatology and Liver Transplantation, North Shore University Hospital at Forest Hills, New York, New York. Furthermore, tolerability and patient compliance with these regimens can be problematic. In a poster session on October 22, Dr. Rayapudi presented results of an open-label, prospective trial into a novel 4-drug regimen consisting of 3 antibiotics and a potent proton pump inhibitor in 30 patients who had failed to respond to any previous H. pylori regimen. The H. pylori diagnosis was made using endoscopy and stool antigen testing. All patients were subsequently given a combination of esomeprazole 40 mg before breakfast, levofloxacin 250 mg at breakfast, nitazoxanide 500 mg twice daily at lunch and dinner, and doxycycline 100 mg at dinner for a total of 10 days. Before initiation of treatment, patients had a washout period of 6 weeks from any prior antibiotic or proton pump inhibitor use. H. pylori eradication was confirmed by stool antigen testing 2 weeks after the end of treatment, Dr. Rayapudi said. In an intent-to-treat analysis, eradication of H. pylori was documented in 90% of 30 patients. By per-protocol analysis, the eradication mounted to 100%. The 3 failures occurred in patients who did not complete the full course of therapy. Two discontinuations were due to nausea and abdominal bloating and 1 due to nonspecific itching that resolved without medical intervention, according to Dr. Rayapudi. This combination offers the advantage of a well-tolerated regimen with minimal in vitro H. pylori resistance and satisfactory therapeutic outcomes, the researchers concluded. A large, randomised, controlled, clinical trial will further establish the therapeutic superiority of this regimen, Dr. Rayapudi said. [Presentation title: LEND (Levofloxacin, Esomeprazole, Nitazoxanide and Doxycycline) for the Treatment of Previously Non-Responsive Helicobacter Pylori. Abstract P1116] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.