PMID- 16684262
OWN - NLM
STAT- MEDLINE
DCOM- 20060712
LR  - 20131121
IS  - 1083-4389 (Print)
IS  - 1083-4389 (Linking)
VI  - 11
IP  - 3
DP  - 2006 Jun
TI  - Efficacy of metronidazole as second-line drug for the treatment of Helicobacter 
      pylori Infection in the Japanese population: a multicenter study in the Tokyo 
      Metropolitan Area.
PG  - 152-8
AB  - BACKGROUND: With the increase in the frequency of clarithromycin-resistant 
      Helicobacter pylori (H. pylori), there is rising concern about the decline of the 
      eradication rate of this infection following treatment. The Tokyo Hp Study Group 
      examined the eradication rate in response to a second-line regimen consisting of 
      proton pump inhibitor (PPI), amoxicillin, and metronidazole by conducting a 
      multicenter study in the Tokyo Metropolitan Area. MATERIALS AND METHODS: Two 
      hundred and twenty-eight patients with H. pylori infection, in whom the 
      first-line therapy with a PPI, amoxicillin, and clarithromycin administered for 1 
      week had failed to eradicate the infection, were enrolled in this study. These 
      cases were randomly assigned to one of the two second-line regimens containing 
      metronidazole (PPI/AM500 or PPI/AM750) administered for 1 week. 13C-urea breath 
      test was performed as a diagnostic method test for H. pylori infection not 
      earlier than 8 weeks after the second-line therapy. RESULTS: Intention-to-treat 
      (ITT) and per-protocol (PP) analyses revealed an eradication rate of 87.6 and 
      90.6%, respectively, following PPI/AM500 treatment, and 86.9 and 88.6%, 
      respectively, following PPI/AM750 treatment. Neither analysis revealed any 
      significant difference in the eradication rate between PPI/AM500 and PPI/AM750 (p 
      = .876 and .621, respectively). According to ITT and PP analyses, the eradication 
      rates following treatment with PPI/AM500 were 85.2 and 88.5% with the use of 
      lansoprazole, 62.5 and 62.5% with the use of omeprazole, and 93.2 and 96.5% with 
      the use of rabeprazole, respectively. There was a significant difference in the 
      eradication rates between PPI (omeprazole)/AM500 and PPI (rabeprazole)/AM500. In 
      the case of PPI/AM750, the corresponding eradication rates were 84.8 and 87.0% 
      with the use of lansoprazole, 92.9 and 92.9% with the use of omeprazole, and 92.9 
      and 92.9% with the use of rabeprazole, respectively. There were no significant 
      differences in the eradication rates obtained with the use of the three PPIs. 
      CONCLUSIONS: Both PPI/AM500 and PPI/AM750 administered for 1 week appeared to be 
      highly effective second-line regimens for the treatment of H. pylori infection in 
      Japanese patients. From the viewpoint of adverse events, PPI/AM500 appeared to be 
      safe compared with PPI/AM750.
FAU - Matsuhisa, Takeshi
AU  - Matsuhisa T
AD  - Tokyo Hp Study Group, Division of Gastroenterology, National Hospital 
      Organization, Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902 
      [corrected] Japan. matuhisa@nms.ac.jp
FAU - Kawai, Takashi
AU  - Kawai T
FAU - Masaoka, Tatsuhiro
AU  - Masaoka T
FAU - Suzuki, Hidekazu
AU  - Suzuki H
FAU - Ito, Masayoshi
AU  - Ito M
FAU - Kawamura, Yo
AU  - Kawamura Y
FAU - Tokunaga, Kengo
AU  - Tokunaga K
FAU - Suzuki, Masayuki
AU  - Suzuki M
FAU - Mine, Tetsuya
AU  - Mine T
FAU - Takahashi, Shin-ichi
AU  - Takahashi S
FAU - Sakaki, Nobuhiro
AU  - Sakaki N
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - England
TA  - Helicobacter
JT  - Helicobacter
JID - 9605411
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - 140QMO216E (Metronidazole)
RN  - 804826J2HU (Amoxicillin)
SB  - IM
EIN - Helicobacter. 2006 Aug;11(4):306
MH  - Adult
MH  - Aged
MH  - Amoxicillin/administration & dosage/adverse effects/therapeutic use
MH  - Anti-Bacterial Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Anti-Ulcer Agents/administration & dosage/therapeutic use
MH  - Drug Administration Schedule
MH  - Drug Therapy, Combination
MH  - Female
MH  - Helicobacter Infections/*drug therapy/microbiology
MH  - Helicobacter pylori/*drug effects
MH  - Humans
MH  - Male
MH  - Metronidazole/administration & dosage/adverse effects/*therapeutic use
MH  - Middle Aged
MH  - Proton Pump Inhibitors
MH  - Retreatment
MH  - Tokyo
MH  - Treatment Outcome
EDAT- 2006/05/11 09:00
MHDA- 2006/07/13 09:00
CRDT- 2006/05/11 09:00
PHST- 2006/05/11 09:00 [pubmed]
PHST- 2006/07/13 09:00 [medline]
PHST- 2006/05/11 09:00 [entrez]
AID - HEL394 [pii]
AID - 10.1111/j.1523-5378.2006.00394.x [doi]
PST - ppublish
SO  - Helicobacter. 2006 Jun;11(3):152-8. doi: 10.1111/j.1523-5378.2006.00394.x.