A community-based study of Helicobacter pylori therapy using the strategy of test, treat, retest, and re-treat initial treatment failures

Yi Chia Lee, Hui Min Wu, Tony Hsiu Hsi Chen, Tzeng Ying Liu, Han Mo Chiu, Chun Chao Chang, Hsiu Po Wang, Ming Shiang Wu, Hung Chiang, Meng Chen Wu, Jaw Town Lin

Research output: Contribution to journalArticle

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Abstract

Background: Although eradication of Helicobacter pylori infection can decrease the risk of gastric cancer, the optimal regimen for treating the general population remains unclear. We report the eradication rate (intention-to-treat and per protocol) of a community-based H. pylori therapy using the strategy of test, treat, retest, and re-treat initial treatment failures. Materials and methods: In 2004, a total of 2658 residents were recruited for 13C-urea breath testing. Participants with positive results for infection received a standard 7-day triple therapy (esomeprazole 40 mg once daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily), and a 10-day re-treatment (esomeprazole 40 mg once daily, amoxicillin 1 g twice daily, and levofloxacin 500 mg once daily) if the follow-up tests remained positive. Both H. pylori status and side-effects were assessed 6 weeks after treatment. Results: Among 886 valid reporters, eradication rates with initial therapy were 86.9% (95% confidence interval [CI]: 84.7-89.1%) and 88.7% (95%CI: 86.5-90.9%) by intention-to-treat and per protocol analysis, respectively. Re-treatment eradicated infection in 91.4% (95%CI: 86-96.8%) of 105 nonresponders. Adequate compliance was achieved in 798 (90.1%) of 886 subjects receiving the initial treatment and in all 105 re-treated subjects. Mild side-effects occurred in 24% of subjects. Overall intention-to-treat and per protocol eradication rates were 97.7% (95%CI: 96.7-98.7%) and 98.8% (95%CI: 98.5-99.3%), respectively, which were only affected by poor compliance (odds ratio, 3.3; 95%CI, 1.99-5.48; p

Original languageEnglish
Pages (from-to)418-424
Number of pages7
JournalHelicobacter
Volume11
Issue number5
DOIs
Publication statusPublished - Oct 2006

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Treatment Failure
Helicobacter pylori
Confidence Intervals
Esomeprazole
Amoxicillin
Therapeutics
Levofloxacin
Clarithromycin
Helicobacter Infections
Infection
Compliance
Stomach Neoplasms
Urea
Odds Ratio
Population

Keywords

  • Antibiotic regimen
  • Gastric cancer
  • Helicobacter pylori
  • Population-based study

ASJC Scopus subject areas

  • Gastroenterology
  • Microbiology

Cite this

A community-based study of Helicobacter pylori therapy using the strategy of test, treat, retest, and re-treat initial treatment failures. / Lee, Yi Chia; Wu, Hui Min; Chen, Tony Hsiu Hsi; Liu, Tzeng Ying; Chiu, Han Mo; Chang, Chun Chao; Wang, Hsiu Po; Wu, Ming Shiang; Chiang, Hung; Wu, Meng Chen; Lin, Jaw Town.

In: Helicobacter, Vol. 11, No. 5, 10.2006, p. 418-424.

Research output: Contribution to journalArticle

Lee, Yi Chia ; Wu, Hui Min ; Chen, Tony Hsiu Hsi ; Liu, Tzeng Ying ; Chiu, Han Mo ; Chang, Chun Chao ; Wang, Hsiu Po ; Wu, Ming Shiang ; Chiang, Hung ; Wu, Meng Chen ; Lin, Jaw Town. / A community-based study of Helicobacter pylori therapy using the strategy of test, treat, retest, and re-treat initial treatment failures. In: Helicobacter. 2006 ; Vol. 11, No. 5. pp. 418-424.
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AU - Lee, Yi Chia

AU - Wu, Hui Min

AU - Chen, Tony Hsiu Hsi

AU - Liu, Tzeng Ying

AU - Chiu, Han Mo

AU - Chang, Chun Chao

AU - Wang, Hsiu Po

AU - Wu, Ming Shiang

AU - Chiang, Hung

AU - Wu, Meng Chen

AU - Lin, Jaw Town

PY - 2006/10

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N2 - Background: Although eradication of Helicobacter pylori infection can decrease the risk of gastric cancer, the optimal regimen for treating the general population remains unclear. We report the eradication rate (intention-to-treat and per protocol) of a community-based H. pylori therapy using the strategy of test, treat, retest, and re-treat initial treatment failures. Materials and methods: In 2004, a total of 2658 residents were recruited for 13C-urea breath testing. Participants with positive results for infection received a standard 7-day triple therapy (esomeprazole 40 mg once daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily), and a 10-day re-treatment (esomeprazole 40 mg once daily, amoxicillin 1 g twice daily, and levofloxacin 500 mg once daily) if the follow-up tests remained positive. Both H. pylori status and side-effects were assessed 6 weeks after treatment. Results: Among 886 valid reporters, eradication rates with initial therapy were 86.9% (95% confidence interval [CI]: 84.7-89.1%) and 88.7% (95%CI: 86.5-90.9%) by intention-to-treat and per protocol analysis, respectively. Re-treatment eradicated infection in 91.4% (95%CI: 86-96.8%) of 105 nonresponders. Adequate compliance was achieved in 798 (90.1%) of 886 subjects receiving the initial treatment and in all 105 re-treated subjects. Mild side-effects occurred in 24% of subjects. Overall intention-to-treat and per protocol eradication rates were 97.7% (95%CI: 96.7-98.7%) and 98.8% (95%CI: 98.5-99.3%), respectively, which were only affected by poor compliance (odds ratio, 3.3; 95%CI, 1.99-5.48; p

AB - Background: Although eradication of Helicobacter pylori infection can decrease the risk of gastric cancer, the optimal regimen for treating the general population remains unclear. We report the eradication rate (intention-to-treat and per protocol) of a community-based H. pylori therapy using the strategy of test, treat, retest, and re-treat initial treatment failures. Materials and methods: In 2004, a total of 2658 residents were recruited for 13C-urea breath testing. Participants with positive results for infection received a standard 7-day triple therapy (esomeprazole 40 mg once daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily), and a 10-day re-treatment (esomeprazole 40 mg once daily, amoxicillin 1 g twice daily, and levofloxacin 500 mg once daily) if the follow-up tests remained positive. Both H. pylori status and side-effects were assessed 6 weeks after treatment. Results: Among 886 valid reporters, eradication rates with initial therapy were 86.9% (95% confidence interval [CI]: 84.7-89.1%) and 88.7% (95%CI: 86.5-90.9%) by intention-to-treat and per protocol analysis, respectively. Re-treatment eradicated infection in 91.4% (95%CI: 86-96.8%) of 105 nonresponders. Adequate compliance was achieved in 798 (90.1%) of 886 subjects receiving the initial treatment and in all 105 re-treated subjects. Mild side-effects occurred in 24% of subjects. Overall intention-to-treat and per protocol eradication rates were 97.7% (95%CI: 96.7-98.7%) and 98.8% (95%CI: 98.5-99.3%), respectively, which were only affected by poor compliance (odds ratio, 3.3; 95%CI, 1.99-5.48; p

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