Articles

Helicobacter Pylori Eradication in Renal Recipient: Triple or Quadruple Therapy?

Abstract

Although triple (omeprazole, amoxicillin, and metronidazole) and quadruple (omeprazole, tetracycline, metronidazole, and bismuth subcitrate) therapeutic regimens for H. pylori eradication has been studied much in the general population, there is a lack of data in renal transplanted patients. So, this study aimed at comparing regimens in these patients who were considered being immunocompromised. The present clinical trial was carried out in Mashhad, Iran in 2010. Fifty-five patients who had received a kidney transplant in six months or earlier and referred for chronic dyspepsia were selected. They were resistant to H2-receptor antagonists or proton pump inhibitors therapy and had positive Rapid ‎Urea Test. They randomly divided into two groups: triple and quadruple therapy. The treatment duration in both groups was similar (antibiotics for two weeks plus omeprazole for 4 weeks). Urea Breath Test (UBT) was performed two weeks after treatment for assessment of its result. Total numbers of 39 patients (71%) were positive for H. Pylori which were divided into triple therapy group (21 patients) and quadruple therapy (18 patients). Overall, the treatment was successful in 80% (71% in triple therapy and 89% in quadruple one) which was not different significantly between the groups (p=0.247). The result of this study revealed that the prevalence of H. pylori infection in renal transplant patients is similar to the normal population. In these cases, triple and quadruple therapies were similar in eradication of H. pylori. So, triple therapy can be recommended in renal transplant recipients.

Ponticelli C, Passerini P. Gastrointestinal complications in renal transplant recipients. Transpl Int 2005;18(6):643-50.

Garvin PJ, Carney K, Castaneda M, et al. Peptic ulcer disease following transplantation: the role of cimetidine. Am J Surg 1982;144(5):545-8.

Jarowenko MV, Van Buren CT, Kramer WG, et al. Ranitidine, cimetidine, and the cyclosporine-treated recipient. Transplantation 1986;42(3):311-2.

Rauws EA, Tytgat GN. Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet 1990;335(8700):1233-5.

Graham DY, Lew GM, Klein PD, et al. Effect of treatment of Helicobacter pylori infection on the long-term recurrence of gastric or duodenal ulcer. A randomized, controlled study. Ann Intern Med 1992;116(9):705-8.

Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1984;1(8390):1311-5.

Asl MK, Nasri H. Prevalence of Helicobacter pylori infection in maintenance hemodialysis patients with nonulcer dyspepsia. Saudi J Kidney Dis Transpl 2009;20(2):223-6.

Teenan RP, Burgoyne M, Brown IL, et al. Helicobacter pylori in renal transplant recipients. Transplantation 1993;56(1):100-3.

Davenport A, Shallcross TM, Crabtree JE, et al. Prevalence of Helicobacter pylori in patients with endstage renal failure and renal transplant recipients. Nephron 1991;59(4):597-601.

Sarkio S, Rautelin H, Kyllonen L, et al. Should Helicobacter pylori infection be treated before kidney transplantation? Nephrol Dial Transplant 2001;16(10):2053-7.

Yildiz A, Besisik F, Akkaya V, et al. Helicobacter pylori antibodies in hemodialysis patients and renal transplant recipients. Clin Transplant 1999;13(1 Pt 1):13-6.

Ozgur O, Boyacioglu S, Ozdogan M, et al. Helicobacter pylori infection in haemodialysis patients and renal transplant recipients. Nephrol Dial Transplant 1997;12(2):289-91.

Abu Farsakh NA, Rababaa M, Abu Farsakh H. Symptomatic, endoscopic and histological assessment of upper gastrointestinal tract in renal transplant recipients. Indian J Gastroenterol 2001;20(1):9-12.

Vakil N, Megraud F. Eradication therapy for Helicobacter pylori. Gastroenterology 2007;133(3):985-1001.

Gerrits MM, van Vliet AH, Kuipers EJ, et al. Helicobacter pylori and antimicrobial resistance: molecular mechanisms and clinical implications. Lancet Infect Dis2006;6(11):699-709.

Osato MS, Reddy R, Reddy SG, et al. Pattern of primary resistance of Helicobacter pylori to metronidazole or clarithromycin in the United States. Arch Intern Med 2001;161(9):1217-20.

Meyer JM, Silliman NP, Wang W, et al. Risk factors for Helicobacter pylori resistance in the United States: the surveillance of H. pylori antimicrobial resistance partnership (SHARP) study, 1993-1999. Ann Intern Med 2002;136(1):13-24.

Moradimoghadam F, Khosravi Khorashad A, Mokhtarifar A. Comparison between quadruples therapy and triple therapy for eradication of Helicobacter Pylori in patients with chronic dyspepsia. Horizon Med Sci 2009;14(4):13-18.

Mantzaris GJ, Petraki K, Archavlis E, et al. Omeprazole triple therapy versus omeprazole quadruple therapy for healing duodenal ulcer and eradication of Helicobacter pylori infection: a 24-month follow-up study. Eur J Gastroenterol Hepatol 2002;14(11):1237-43.

Choi J, Jang JY, Kim JS, et al. Efficacy of two triple eradication regimens in children with Helicobacter pylori infection. J Korean Med Sci 2006;21(6):1037-40.

Catalano F, Catanzaro R, Bentivegna C, et al. Ranitidine bismuth citrate versus omeprazole triple therapy for the eradication of Helicobacter pylori and healing of duodenal ulcer. Aliment Pharmacol Ther 1998;12(1):59-62.

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IssueVol 52, No 4 (2014) QRcode
SectionArticles
Keywords
Renal transplantation Triple therapy Quadruple therapy Helicobacter pylori Dyspepsia

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How to Cite
1.
Hosseini SMR, Sharifipoor F, Nazemian F, Ghanei H, Zivarifar HR, Fakharian T. Helicobacter Pylori Eradication in Renal Recipient: Triple or Quadruple Therapy?. Acta Med Iran. 1;52(4):271-274.