amoxicillin and metronidazole for h pylori geodon

); the Outpatient Department South, Regional Public Medical Insurance, Vienna (B.D. The difference between the groups was significant according to the log-rank test.Tap into groundbreaking research and clinically relevant insights The rate of recurrence of duodenal ulcer is low when patients receive a treatment designed to eradicate Helicobacter pylori. Of the 153 clinical isolates of H pylori found in a previous study, 71.9% are resistant to amoxicillin, 77.8% to metronidazole, and 39.2% to both. Because both the culture and one of the other two tests of these specimens were clearly negative, and because each weakly positive result was followed by a clearly negative result at the next scheduled appointment, these specimens were classified as negative for H. pylori.Differences between the two study groups in the incidence of ulcer healing and eradication of H. pylori, as well as the cumulative rate of recurrence of duodenal ulcer after follow-up of 12 months, were assessed with the chi-square test. -- all in Austria.Address reprint requests to Dr. Hentschel at Hanusch Hospital, Medical Department I, Heinrich-Collinstr. The difference between the groups was significant according to the log-rank test.The probability of remaining in remission is shown in We found that healing of recurrent duodenal ulcers occurred in more of the patients treated with ranitidine and antibiotics than the patients treated with ranitidine and placebo. Patients with healing and no recurrence during 12 months of follow-up were considered to have completed the study. Our primary objective was to test the hypothesis that the eradication of H. pylori can prevent the recurrence of duodenal ulcer. 2000 Jun;14(6):751-8. doi: 10.1046/j.1365-2036.2000.00776.x.Sokic-Milutinovic A, Todorovic V, Milosavljevic T, Micev M, Drndarevic N, Mitrovic O.World J Gastroenterol. They were referred by their general practitioners, with the exception of 27 who had taken part at least six months earlier in trials involving short-term and maintenance treatment of duodenal ulcer with pirenzepine, various histamine-receptor antagonists, sucralfate, and omeprazole. For this study, they were evaluated only for the presence or absence of H. pylori.The identification of H. pylori was based on the results of culture, histologic examination, and the rapid urease test of biopsy specimens. A secondary objective was to evaluate the efficacy and safety of the combination of antibiotics when given with ranitidine.The study protocol was approved by the appropriate institutional review committees, and written informed consent was obtained from all patients.We studied 104 patients who had had at least two symptomatic recurrences of duodenal ulcer, diagnosed by endoscopy or radiography, that were separated by a symptom-free period of at least three months. During the one-year course of the study, 19 of 164 specimens that were negative for H. pylori on culture were equivocal or weakly positive on either histologic examination (11 specimens) or urease testing (8 specimens). Ulcers recurred in 1 of 46 patients in whom H. pylori had been eradicated, as compared with 45 of 53 in whom H. pylori persisted (2 percent vs. 85 percent, P<0.001).In patients with recurrent duodenal ulcer, eradication of H. pylori by a regimen that does not have any direct action on the mucosa is followed by a marked reduction in the rate of recurrence, suggesting a causal role for H. pylori in recurrent duodenal ulcer. Special attention was paid to rinsing all channels of each endoscope with this solution. The study reported here meets these requirements: amoxicillin and metronidazole are effective against H. pylori and are not known to have direct actions on the mucosa. After six weeks, the ulcers were healed in 48 patients given antibiotics and 39 given placebo (92 percent vs. 75 percent, P = 0.011). Seven patients had diarrhea, with four to seven bowel movements per day; six of these patients completed the 12-day period of antibiotic treatment, after which the diarrhea subsided.

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