One week eradication therapy for helicobacter pylori

1. To determine the efficacy of one week treatment in the cure of Helicobacter Pylori [H pylori] infection using triple regimen including Clarithromycin, Amoxicillin, and a Proton Pump Inhibitor [PPI]. 2. To identify the differences, if any, in response to treatment between patients from Pakistan and the rest of the world. Patients with endoscopically proven peptic ulcer disease and H pylori infection confirmed by urease test were given PPI based triple therapy for one week and then PPI was continued for another week. After two weeks, endoscopy and urease test was repeated to assess H pylori eradication. There were 32 patients [20 male, 12 female, mean age 38.9 years] included in the study. All had endoscopically proven peptic ulcer at initial diagnosis and all were positive for H pylori infection. On repeat endoscopy two weeks later, 27 patients [84.3%] showed complete ulcer healing and PPI was stopped, whereas 5 patients showed signs of partial healing. In the latter, PPI was continued for another week, and on repeat endoscopy at end of therapy, all ulcers showed complete healing. Urease test was repeated in all patients at second endoscopy and was negative in 28 patients [87.5%]. We conclude that one week of triple therapy followed by PPI for one week is sufficient for eradication of H Pylorl

One week eradication therapy for Helicobacter pylori

Studies have been published from most parts of the world regarding optimal duration of treatment for peptic ulcer disease and for eradication of Helicobacter Pylori with some statistical differences therein. Worldwide consensus on this issue has still not been reached. The primary objective of the present study was to elucidate the role of the duration of treatment in the cure of H. Pylori infection. We aimed to determine whether one-week triple therapy is effective for eradication of H Pylori, so that a cost-effective protocol could be developed. Also to see if there was any difference in response in patients from this part of the world, as no such study has been previously reported from Pakistan. Patients with endoscopically proven peptic ulcer disease and H Pylori status confirmed by urease test were given PPI based triple therapy for one week and then PPI was continued for another week. After two weeks, endoscopy and urease test was repeated to assess H Pylori eradication. There were 32 patients [20 male, 12 female, mean age 38.9 years] included in the study. All had endoscopically proven peptic ulcer at initial diagnosis and all were positive for H Pylori infection. On repeat endoscopy two weeks later 27 patients [84.3%] showed complete ulcer healing 'and PPI was stopped, whereas 5 patients showed signs of partial healing. In the lattei PPI was continued for another week, and on repeat endoscopy at end of therapy, all ulcers showed complete healing. Urease test was repeated in all patients at second endoscopy and was negative in 28 patients [87.5%]. Our results were in keeping with other similar studies from different parts of the world. We conclude that one week of triple therapy is sufficient for eradication of H Pylori

Incidence of spontaneous bacterial peritonitis in liver cirrhosis, the causative organisms and antibiotic sensitivity

To find out the incidence of spontaneous bacterial peritonitis in patients with liver cirrhosis having ascites, the causative organisms and their antibiotic sensitivity. This study was conducted in Medical Ward of Khyber Teaching Hospital, Peshawar from 1st June 2001 to 31 of March 2003. Patients having liver cirrhosis confirmed previously by histopathology and now presenting with fever with or without chills, abdominal discomfort, increasing abdominal distension, confusion and hepatic encephalopathy, were included. A total of 200 patients were studied. Out of 200 patients included, spontaneous bacterial peritonitis [SBP] was present in 102 patients. Classical SBP was present in 38.23%; Culture Negative Neutrocytic Ascites [CNNA] was present in 57.84% while Bacterascites was present in 03.92% of patients. E Coli was isolated in 58.13%, Streptococcus pneumoniae in 18.60%, Staphylococcus auras in 09.13%, Klebsiella in 09.13% and Acinetobacter in 04.65%. Out of 102 cases of SBP, blood cultures were positive in 21.56%, urine cultures in 15.68% and throat swabs in 10.78% of patients. E Coli was again the commonest organism isolated from blood cultures. All the organisms were sensitive to 3rd generation cephalosporins, and quinolones. Spontaneous bacterial peritonitis is quite a common complication of liver cirrhosis with ascites. Patients usually present with abdominal pain, abdominal tenderness, fever with or without rigors, jaundice, and hepatic encephalopathy. E Coli is the commonest organism followed by streptococcal pnaemoniae. Quinolones and 3rd generation cephalosporins are 100% effective in the management of spontaneous bacterial peritonitis