Efficacy of Omeprazole, Tetracycline, and 4 Times Daily Dosing of Amoxicillin in Helicobacter pylori Eradication in Limited Resource Area in Bhutan: A Prospective Randomized Trial (BHUTAN Study)
Backgrourd: H. pylori-associated gastric cancer is the first cancer-related death in Bhutan. Effective regimen for H. pylori eradication is essential to reduce risk of developing gastric cancer. Clarithromycin is not widely used in this limited resource country. Aim of this study was to evaluate pro...
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| Veröffentlicht in: | Asian Pacific Journal of Cancer Prevention 2020-04, Vol.21 (4), p.1109-1114 |
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| creator | Vilaichone, Ratha-Korn Aumpan, Natsuda Ratanachu-Ek, Thawee Gamnarai, Pornpen Uchida, Tomahisa Tshering, Lotay Mahachai, Varocha Yamaoka, Yoshio |
| description | Backgrourd: H. pylori-associated gastric cancer is the first cancer-related death in Bhutan. Effective regimen for H. pylori eradication is essential to reduce risk of developing gastric cancer. Clarithromycin is not widely used in this limited resource country. Aim of this study was to evaluate proper regimen and prevalence of antibiotic resistance pattern for H. pylori eradication in Bhutan.
Five hundred and forty-six patients underwent gastroscopy during GASTROCAMP between October 2014 and April 2015 in Bhutan and 77 patients were enrolled. Four gastric biopsies were obtained for rapid urease test, histopathology, H. pylori culture with Epsilometer test. All H. pylori-positive patients were randomized to receive either 7-day or 14-day of 500 mg amoxicillin four times daily, 500 mg tetracycline four times daily, and 20 mg omeprazole twice daily.
Seventy-seven subjects were enrolled (54 females, 23 males, mean age = 45.4 years). Of 77 patients, 52 (67.5%) received 7-day regimen while 25 (32.5%) had 14-day regimen. Prevalence of H. pylori was 38.2%. Antibiotic resistance was 80.0% for metronidazole, 11.1% for levofloxacin and no resistance seen in amoxicillin, tetracycline and clarithromycin. Overall eradication rates of 7-day and 14-day regimens were 51.9% and 80.0%, p = 0.02. Female and age ≥40 years had significantly higher eradication rate when receiving 14-day compared to 7-day regimen (94.1% vs. 45.9%, OR = 18.82; 95% CI 2.26-157.02, p = 0.0007 and 86.7% vs. 50.0%, OR = 6.50; 95% CI 1.25-33.91, p = 0.02, respectively).
Fourteen-day regimen might be an acceptable regimen for H. pylori eradication in limited resource area such as Bhutan. Female and age ≥40 years should receive longer duration of treatment. This 14-day regimen could at least reduce the risk of developing H. pylori-associated diseases especially peptic ulcer with complications and gastric cancer which lead to many deaths in Bhutan.
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| doi_str_mv | 10.31557/apjcp.2020.21.4.1109 |
| format | Article |
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Five hundred and forty-six patients underwent gastroscopy during GASTROCAMP between October 2014 and April 2015 in Bhutan and 77 patients were enrolled. Four gastric biopsies were obtained for rapid urease test, histopathology, H. pylori culture with Epsilometer test. All H. pylori-positive patients were randomized to receive either 7-day or 14-day of 500 mg amoxicillin four times daily, 500 mg tetracycline four times daily, and 20 mg omeprazole twice daily.
Seventy-seven subjects were enrolled (54 females, 23 males, mean age = 45.4 years). Of 77 patients, 52 (67.5%) received 7-day regimen while 25 (32.5%) had 14-day regimen. Prevalence of H. pylori was 38.2%. Antibiotic resistance was 80.0% for metronidazole, 11.1% for levofloxacin and no resistance seen in amoxicillin, tetracycline and clarithromycin. Overall eradication rates of 7-day and 14-day regimens were 51.9% and 80.0%, p = 0.02. Female and age ≥40 years had significantly higher eradication rate when receiving 14-day compared to 7-day regimen (94.1% vs. 45.9%, OR = 18.82; 95% CI 2.26-157.02, p = 0.0007 and 86.7% vs. 50.0%, OR = 6.50; 95% CI 1.25-33.91, p = 0.02, respectively).
Fourteen-day regimen might be an acceptable regimen for H. pylori eradication in limited resource area such as Bhutan. Female and age ≥40 years should receive longer duration of treatment. This 14-day regimen could at least reduce the risk of developing H. pylori-associated diseases especially peptic ulcer with complications and gastric cancer which lead to many deaths in Bhutan.
.</description><identifier>ISSN: 2476-762X</identifier><identifier>ISSN: 1513-7368</identifier><identifier>EISSN: 2476-762X</identifier><identifier>DOI: 10.31557/apjcp.2020.21.4.1109</identifier><identifier>PMID: 32334478</identifier><language>eng</language><publisher>Thailand: West Asia Organization for Cancer Prevention</publisher><subject>Adolescent ; Adult ; Aged ; Amoxicillin - therapeutic use ; Anti-Bacterial Agents - therapeutic use ; Bhutan - epidemiology ; Developing Countries ; Female ; Follow-Up Studies ; Helicobacter Infections - drug therapy ; Helicobacter Infections - epidemiology ; Helicobacter Infections - microbiology ; Helicobacter pylori - drug effects ; Helicobacter pylori - isolation & purification ; Humans ; Male ; Middle Aged ; Omeprazole - therapeutic use ; Prognosis ; Prospective Studies ; Socioeconomic Factors ; Tetracycline - therapeutic use ; Young Adult</subject><ispartof>Asian Pacific Journal of Cancer Prevention, 2020-04, Vol.21 (4), p.1109-1114</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3929-9dee000af86dfdb4f98e6d1eb7f25774461946ff78f1869d92188fddfa9884dc3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445957/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445957/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32334478$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vilaichone, Ratha-Korn</creatorcontrib><creatorcontrib>Aumpan, Natsuda</creatorcontrib><creatorcontrib>Ratanachu-Ek, Thawee</creatorcontrib><creatorcontrib>Gamnarai, Pornpen</creatorcontrib><creatorcontrib>Uchida, Tomahisa</creatorcontrib><creatorcontrib>Tshering, Lotay</creatorcontrib><creatorcontrib>Mahachai, Varocha</creatorcontrib><creatorcontrib>Yamaoka, Yoshio</creatorcontrib><title>Efficacy of Omeprazole, Tetracycline, and 4 Times Daily Dosing of Amoxicillin in Helicobacter pylori Eradication in Limited Resource Area in Bhutan: A Prospective Randomized Trial (BHUTAN Study)</title><title>Asian Pacific Journal of Cancer Prevention</title><addtitle>Asian Pac J Cancer Prev</addtitle><description>Backgrourd: H. pylori-associated gastric cancer is the first cancer-related death in Bhutan. Effective regimen for H. pylori eradication is essential to reduce risk of developing gastric cancer. Clarithromycin is not widely used in this limited resource country. Aim of this study was to evaluate proper regimen and prevalence of antibiotic resistance pattern for H. pylori eradication in Bhutan.
Five hundred and forty-six patients underwent gastroscopy during GASTROCAMP between October 2014 and April 2015 in Bhutan and 77 patients were enrolled. Four gastric biopsies were obtained for rapid urease test, histopathology, H. pylori culture with Epsilometer test. All H. pylori-positive patients were randomized to receive either 7-day or 14-day of 500 mg amoxicillin four times daily, 500 mg tetracycline four times daily, and 20 mg omeprazole twice daily.
Seventy-seven subjects were enrolled (54 females, 23 males, mean age = 45.4 years). Of 77 patients, 52 (67.5%) received 7-day regimen while 25 (32.5%) had 14-day regimen. Prevalence of H. pylori was 38.2%. Antibiotic resistance was 80.0% for metronidazole, 11.1% for levofloxacin and no resistance seen in amoxicillin, tetracycline and clarithromycin. Overall eradication rates of 7-day and 14-day regimens were 51.9% and 80.0%, p = 0.02. Female and age ≥40 years had significantly higher eradication rate when receiving 14-day compared to 7-day regimen (94.1% vs. 45.9%, OR = 18.82; 95% CI 2.26-157.02, p = 0.0007 and 86.7% vs. 50.0%, OR = 6.50; 95% CI 1.25-33.91, p = 0.02, respectively).
Fourteen-day regimen might be an acceptable regimen for H. pylori eradication in limited resource area such as Bhutan. Female and age ≥40 years should receive longer duration of treatment. This 14-day regimen could at least reduce the risk of developing H. pylori-associated diseases especially peptic ulcer with complications and gastric cancer which lead to many deaths in Bhutan.
.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Amoxicillin - therapeutic use</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Bhutan - epidemiology</subject><subject>Developing Countries</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Helicobacter Infections - drug therapy</subject><subject>Helicobacter Infections - epidemiology</subject><subject>Helicobacter Infections - microbiology</subject><subject>Helicobacter pylori - drug effects</subject><subject>Helicobacter pylori - isolation & purification</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Omeprazole - therapeutic use</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Socioeconomic Factors</subject><subject>Tetracycline - therapeutic use</subject><subject>Young Adult</subject><issn>2476-762X</issn><issn>1513-7368</issn><issn>2476-762X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkdFu0zAUhiMEYmPwCCBfgkSD7TixzQVS1hUKqlg1Ook7y7WPN09JHDnptOzx9mS4G0xDsmQfn_P9v-w_y94SnBekLPkn3V-ZPqeY4pySnOWEYPksO6SMVzNe0d_Pn5wPslfDcIUxKwUvX2YHBS0Kxrg4zO4WznmjzYSCQ6ct9FHfhgY-og2MMV2bxnep0p1FDG18CwM60b6Z0EkYfHexp-o23HjjmzSJ0lpC403YajNCRP3UhOjRImqbXEYf7kdWvvUjWHQGQ9hFA6iOoPeN48vdqLvPqEbrGIYezOivAZ0l99D620RsotcNen-8PN_UP9GvcWenD6-zF043A7z5ux9l518Xm_lytjr99n1er2amkFTOpAXAGGsnKuvsljkpoLIEttzRknPGKiJZ5RwXjohKWkmJEM5ap6UQzJriKPvyoNvvti1YA136oUb10bc6Tipor_7vdP5SXYRrlbRLWfIkUD4ImPS4IYJ7ZAlW96Gqev1jvlb7UBUliql9qIl799T4kfqXYvEHl1Oi3g</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Vilaichone, Ratha-Korn</creator><creator>Aumpan, Natsuda</creator><creator>Ratanachu-Ek, Thawee</creator><creator>Gamnarai, Pornpen</creator><creator>Uchida, Tomahisa</creator><creator>Tshering, Lotay</creator><creator>Mahachai, Varocha</creator><creator>Yamaoka, Yoshio</creator><general>West Asia Organization for Cancer Prevention</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20200401</creationdate><title>Efficacy of Omeprazole, Tetracycline, and 4 Times Daily Dosing of Amoxicillin in Helicobacter pylori Eradication in Limited Resource Area in Bhutan: A Prospective Randomized Trial (BHUTAN Study)</title><author>Vilaichone, Ratha-Korn ; Aumpan, Natsuda ; Ratanachu-Ek, Thawee ; Gamnarai, Pornpen ; Uchida, Tomahisa ; Tshering, Lotay ; Mahachai, Varocha ; Yamaoka, Yoshio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3929-9dee000af86dfdb4f98e6d1eb7f25774461946ff78f1869d92188fddfa9884dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Amoxicillin - therapeutic use</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Bhutan - epidemiology</topic><topic>Developing Countries</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Helicobacter Infections - drug therapy</topic><topic>Helicobacter Infections - epidemiology</topic><topic>Helicobacter Infections - microbiology</topic><topic>Helicobacter pylori - drug effects</topic><topic>Helicobacter pylori - isolation & purification</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Omeprazole - therapeutic use</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Socioeconomic Factors</topic><topic>Tetracycline - therapeutic use</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vilaichone, Ratha-Korn</creatorcontrib><creatorcontrib>Aumpan, Natsuda</creatorcontrib><creatorcontrib>Ratanachu-Ek, Thawee</creatorcontrib><creatorcontrib>Gamnarai, Pornpen</creatorcontrib><creatorcontrib>Uchida, Tomahisa</creatorcontrib><creatorcontrib>Tshering, Lotay</creatorcontrib><creatorcontrib>Mahachai, Varocha</creatorcontrib><creatorcontrib>Yamaoka, Yoshio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Asian Pacific Journal of Cancer Prevention</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vilaichone, Ratha-Korn</au><au>Aumpan, Natsuda</au><au>Ratanachu-Ek, Thawee</au><au>Gamnarai, Pornpen</au><au>Uchida, Tomahisa</au><au>Tshering, Lotay</au><au>Mahachai, Varocha</au><au>Yamaoka, Yoshio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of Omeprazole, Tetracycline, and 4 Times Daily Dosing of Amoxicillin in Helicobacter pylori Eradication in Limited Resource Area in Bhutan: A Prospective Randomized Trial (BHUTAN Study)</atitle><jtitle>Asian Pacific Journal of Cancer Prevention</jtitle><addtitle>Asian Pac J Cancer Prev</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>21</volume><issue>4</issue><spage>1109</spage><epage>1114</epage><pages>1109-1114</pages><issn>2476-762X</issn><issn>1513-7368</issn><eissn>2476-762X</eissn><abstract>Backgrourd: H. pylori-associated gastric cancer is the first cancer-related death in Bhutan. Effective regimen for H. pylori eradication is essential to reduce risk of developing gastric cancer. Clarithromycin is not widely used in this limited resource country. Aim of this study was to evaluate proper regimen and prevalence of antibiotic resistance pattern for H. pylori eradication in Bhutan.
Five hundred and forty-six patients underwent gastroscopy during GASTROCAMP between October 2014 and April 2015 in Bhutan and 77 patients were enrolled. Four gastric biopsies were obtained for rapid urease test, histopathology, H. pylori culture with Epsilometer test. All H. pylori-positive patients were randomized to receive either 7-day or 14-day of 500 mg amoxicillin four times daily, 500 mg tetracycline four times daily, and 20 mg omeprazole twice daily.
Seventy-seven subjects were enrolled (54 females, 23 males, mean age = 45.4 years). Of 77 patients, 52 (67.5%) received 7-day regimen while 25 (32.5%) had 14-day regimen. Prevalence of H. pylori was 38.2%. Antibiotic resistance was 80.0% for metronidazole, 11.1% for levofloxacin and no resistance seen in amoxicillin, tetracycline and clarithromycin. Overall eradication rates of 7-day and 14-day regimens were 51.9% and 80.0%, p = 0.02. Female and age ≥40 years had significantly higher eradication rate when receiving 14-day compared to 7-day regimen (94.1% vs. 45.9%, OR = 18.82; 95% CI 2.26-157.02, p = 0.0007 and 86.7% vs. 50.0%, OR = 6.50; 95% CI 1.25-33.91, p = 0.02, respectively).
Fourteen-day regimen might be an acceptable regimen for H. pylori eradication in limited resource area such as Bhutan. Female and age ≥40 years should receive longer duration of treatment. This 14-day regimen could at least reduce the risk of developing H. pylori-associated diseases especially peptic ulcer with complications and gastric cancer which lead to many deaths in Bhutan.
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free E- Journals |
| subjects | Adolescent Adult Aged Amoxicillin - therapeutic use Anti-Bacterial Agents - therapeutic use Bhutan - epidemiology Developing Countries Female Follow-Up Studies Helicobacter Infections - drug therapy Helicobacter Infections - epidemiology Helicobacter Infections - microbiology Helicobacter pylori - drug effects Helicobacter pylori - isolation & purification Humans Male Middle Aged Omeprazole - therapeutic use Prognosis Prospective Studies Socioeconomic Factors Tetracycline - therapeutic use Young Adult |
| title | Efficacy of Omeprazole, Tetracycline, and 4 Times Daily Dosing of Amoxicillin in Helicobacter pylori Eradication in Limited Resource Area in Bhutan: A Prospective Randomized Trial (BHUTAN Study) |
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