10-day Versus 14-day Concomitant PAMC as First-line Treatment Strategy for the Eradication of H. Pylori Infection
Status:
Completed
Trial end date:
2017-12-30
Target enrollment:
Participant gender:
Summary
Helicobacter pylori (H. pylori) infection is highly associated with gastrointestinal
disorders, including peptic ulcer disease, gastric cancer, and gastric mucosa associated
lymphoid tissue lymphoma.1 In 1994, H. pylori was classified as a group carcinogen by the
International Agency for Research on Cancer. Since then, many consensus conferences and
clinical guidelines worldwide have been established for the treatment of H. pylori infection.
Despite H. pylori infecting an estimated 50% of the global population,there is no universally
effective regimen in everyday clinical practice. The current European Helicobacter Study
Group Guidelines for the first line empirical treatment of the H. pylori infection propose a
variety of treatment strategies, as optimal treatment of H. pylori infection requires careful
attention to local antibiotic resistance and eradication patterns. Most recently, the Toronto
Consensus for the Treatment of Helicobacter pylori Infection in Adults strongly recommended
that all H. pylori eradication regimens now be given for 14 days. Recommended first-line
strategies include concomitant nonbismuth quadruple therapy (proton pump inhibitor [PPI] +
amoxicillin + metronidazole + clarithromycin [PAMC]) and traditional bismuth quadruple
therapy (PPI + bismuth + metronidazole + tetracycline [PBMT]).The aforementioned statement by
an international working group of specialists chosen by the Canadian Association of
Gastroenterology is of the outmost importance, especially in countries with increased
antibiotic resistance, like Greece, with resistance rates >20% to clarithromycin and >40% to
metronidazole.