[The role of tetracycline in the retreatment after Helicobacter pylori eradication failure]

Author(s): Auriemma L, Signorelli S

Affiliation(s): Laboratorio Analisi Chimico-Cliniche e Microbiologiche, Ospedale Bolognini, Seriate, Bergamo, Italy.

Publication date & source: 2001-06, Minerva Med., 92(3):145-9.

Publication type: Clinical Trial; English Abstract; Randomized Controlled Trial

BACKGROUND: To study the effect of second-line treatment with tetracycline (T) combination therapy in patients with Helicobacter pylori (H. pylori) infection after failure of triple one-week therapy with a proton pump inhibitor, omeprazole (O) with amoxycillin (A) and claritromycin (C) or metronidazole (M). METHODS: Three hundred twenty-five naive patients (146 males, 179 females, mean age 50, range 18-76), with H. pylori infection, were randomised to receive one-week triple therapy b.i.d. with O 20 mg; A 1 g; C 500 mg (OAC7 163 pts) or O 20 mg; A 1 g; M 500 mg (OAM7 162 pts). H. pylori status was determined before therapy by histology and 3 months after the end of treatment by C-13 urea breath test (UBT). When eradication did not occur, the patients were retreated with OTA7: O 20 mg b.i.d.; T 500 mg t.i.d. and A1 g b.i.d. for another week. H. pylori was assessed by C-13 UBT 3 months after the end of retreatment. Statistical analysis was done by c2 and Student t test. RESULTS: Three hundred and ten patients have completed the study with compliance >95%: 15 patients complained of side effects (diarrhea, nausea, urticaria, abdominal pain): 9 group OAC7, 6 group OAM7. After the first treatment h. pylori eradication were obtained in 124/154 (80.5%) (PP) OAC7 group and 123/156 (78.8%) (PP) OAM7 group (ns). 49/63 patients (77.7%) were negative after second-line treatment with OTA7 regimen. CONCLUSIONS: In personal experience the drug compliance was excellent. The rate of eradication after one-week therapy-omeprazole combined with A+C or with A+M-was satisfactory. The retreatment with tetracycline combination regimen cured 77.7% of patients: that seems to be a promising options, in clinical practice, after an eradication failure.