Terapia triple de corto tiempo con azitromicina, amoxicilina y omeprazol para la erradicación del helicobacter pylori / Short-term therapy with azithromycin, amoxycilin and omeprazole for the eradication of helicobacter pylori

Background: the high cost and complexity of therapeutic schemes for the eradication of Helicobacter pylori has stimulated the search of simpler and cheaper treatment options. Aim: To evaluate the efficacy of 3 days of azithromycin 500 mg od, 7 days of amoxycilin 750 mg tid and omeprazole, 20 (Group A) or 40 mg (Group B) on randomization, as a treatment for Helicobacter pylori infection in patients with endoscopically diagnosed peptic ulcer. Methods: H. pylori status of peptic ulcer patients was pathologically confirmed by the examination of five gastric biopsies using the Giemsa stain and by rapid urease testing in two gastric biopsies. H. pylori status was reassessed not less than 28 days after completing treatment. Adverse events and compliance were evaluated. Results: Fifty four patients (29 men, 25 women, mean age 48 years) were enrolled, 28 in Group A and 27 in Group B. Per protocol the infection was cured in 58,8 percent of patients (30/51; 95 percent CI: 45-73 percent). On an intention to treat basis, H pylori infection was cured in 55 percent. Minor side effects including diarrhea and nausea were reported by 32 percent of patients. Ninety five per cent of patients consumed more than 95 percent of prescribed medications. H. pylori was successfully erradicated in 61 percent of group A and 57 percent of group B patients (p= NS). Conclusion: Short term therapy with azithromycin was poorly effective in curing H. pylori infection. The compliance was excellent. Increasing Omeprazole from 20 to 40 mg/day did not improve treatment effectiveness

Leptospirosis: revisión a propósito de dos casos / Leptospirosis: review apropos of two cases

En la última década la humanidad ha sido víctima de una variedad de infecciones nuevas y desconocidas y otras reemergentes, que aumentan las posibilidades de diagnósticos diferencial. La Leptospirosis, una infección muy rara en Chile., nos ha hecho recordarla a raíz de dos casos que se presentaron con un síndrome séptico febril con ictericia, falla renal y uno de ellos con una neumonia atípica. Se hace una revisión de la literatura y se muestra la necesidad de tener en mente esta enfermedad, por su variedad de presentación, para lograr un diagnóstico y tratamiento oportunos.