Re: H PYLORI STILL POSITIVE
Posted: Wed Aug 28, 2013 3:01 pm
Dear Helico_expert
While continually searching for developments across the globe to successfully treat H pylori infection, I recently ran into the following article of Dr Alessandro Federico MD from the university of Naples in Italy. This gastroeneterologist and his colleagues are favoring a 5-day concomitant ( simultaneous, parallel) treatment ( regimen) to effectively eradicate HP infection and they found stunning success of this regimen which consists of esomeprazole 40 mg twice daily, amoxicillin 1g twice daily, levofloxacin 500 mg twice daily, and tinidazole 500 mg twice daily for 5 days. here below my post is an excerpt of their article.
could I pls request you to let me have your opinion on this please
They are recommending almost the same regimen as you guys are on helico.com except that you guys favor a SEQUENTIAL regimen while these guys are recommending a SIMULTANEOUS ( concomitant) regimen. If I ever take their therapy I would make sure I have the regimen for at least seven days. Can I have your views on their recommendation pls helico_expert? Many many thanks in advance !
While continually searching for developments across the globe to successfully treat H pylori infection, I recently ran into the following article of Dr Alessandro Federico MD from the university of Naples in Italy. This gastroeneterologist and his colleagues are favoring a 5-day concomitant ( simultaneous, parallel) treatment ( regimen) to effectively eradicate HP infection and they found stunning success of this regimen which consists of esomeprazole 40 mg twice daily, amoxicillin 1g twice daily, levofloxacin 500 mg twice daily, and tinidazole 500 mg twice daily for 5 days. here below my post is an excerpt of their article.
could I pls request you to let me have your opinion on this please
They are recommending almost the same regimen as you guys are on helico.com except that you guys favor a SEQUENTIAL regimen while these guys are recommending a SIMULTANEOUS ( concomitant) regimen. If I ever take their therapy I would make sure I have the regimen for at least seven days. Can I have your views on their recommendation pls helico_expert? Many many thanks in advance !
"June 3, 2012 — A 5-day levofloxacin-containing concomitant regimen effectively eradicates Helicobacter pylori infection as effectively as a 10-day sequential regimen, according to the findings of a prospective, randomized controlled trial.
Alessandro Federico, MD, from the Second University of Naples in Italy, and colleagues reported their findings in an article published online April 5 and in the July issue of Gastroenterology.
The authors note that resistance has limited the efficacy of many regimens currently used to treat H pylori infection. "Although H pylori is susceptible to a number of antimicrobials, H pylori infection has proven challenging to cure because the prevalence of bacterial strains resistant to the most commonly used antimicrobials, in particular clarithromycin...increases," the authors write.
"As a result, currently recommended first-line therapies both in the United States and Europe achieve a 75%-80% eradication rate, which is not acceptable."
The authors compared the efficacy of 5-day simultaneous therapy (esomeprazole 40 mg twice daily, amoxicillin 1g twice daily, levofloxacin 500 mg twice daily, and tinidazole 500 mg twice daily for 5 days) to that of 10-day sequential therapy (esomeprazole 40 mg twice daily and amoxicillin 1 g twice daily for 5 days followed by esomeprazole 40 mg twice daily, levofloxacin 500 mg twice daily, and tinidazole 500 mg twice daily for 5 days) in a group of 180 patients (n = 90 each group). In the intention-to-treat analysis, the 5-day regimen achieved a similar eradication rate as the 10-day regimen (5-day: 83/90 patients [92.2%; 95% confidence interval [CI], 84.0% - 95.8%]; 10-day: 84/90 patients [93.3%; 95% CI, 86.9% - 97.3%; P = .774).
The authors included patients at least 18 years of age who had confirmed H pylori infection (according to 13C urea breath test positivity or both the rapid urease test and histology in patients who underwent endoscopy) and who had never received eradication treatment. The exclusion criteria included previous treatment for H pylori infection, previous use of acid secretion inhibitors and/or antibiotics in the 6 weeks before the study, and gastrointestinal malignancy."