tetracycline and Gastrointestinal-Hemorrhage

Many patients who have had upper gastrointestinal bleeding continue to take low-dose aspirin for cardiovascular prophylaxis or other non-steroidal antiinflammatory drugs (NSAIDs) for musculoskeletal pain. It is uncertain whether infection with Helicobacter pylori is a risk factor for bleeding in such patients.. We studied patients with a history of upper gastrointestinal bleeding who were infected with H. pylori and who were taking low-dose aspirin or other NSAIDs. We evaluated whether eradication of the infection or omeprazole treatment was more effective in preventing recurrent bleeding. We recruited patients who presented with upper gastrointestinal bleeding that was confirmed by endoscopy. Their ulcers were healed by daily treatment with 20 mg of omeprazole for eight weeks or longer. Then, those who had been taking aspirin were given 80 mg of aspirin daily, and those who had been taking other NSAIDs were given 500 mg of naproxen twice daily for six months. The patients in each group were then randomly assigned separately to receive 20 mg of omeprazole daily for six months or one week of eradication therapy, consisting of 120 mg of bismuth subcitrate, 500 mg of tetracycline, and 400 mg of metronidazole, all given four times daily, followed by placebo for six months.. We enrolled 400 patients (250 of whom were taking aspirin and 150 of whom were taking other NSAIDs). Among those taking aspirin, the probability of recurrent bleeding during the six-month period was 1.9 percent for patients who received eradication therapy and 0.9 percent for patients who received omeprazole (absolute difference, 1.0 percent; 95 percent confidence interval for the difference, -1.9 to 3.9 percent). Among users of other NSAIDs, the probability of recurrent bleeding was 18.8 percent for patients receiving eradication therapy and 4.4 percent for those treated with omeprazole (absolute difference, 14.4 percent; 95 percent confidence interval for the difference, 4.4 to 24.4 percent; P=0.005).. Among patients with H. pylori infection and a history of upper gastrointestinal bleeding who are taking low-dose aspirin, the eradication of H. pylori is equivalent to treatment with omeprazole in preventing recurrent bleeding. Omeprazole is superior to the eradication of H. pylori in preventing recurrent bleeding in patients who are taking other NSAIDs.

Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Aspirin; Drug Therapy, Combination; Gastrointestinal Hemorrhage; Helicobacter Infections; Helicobacter pylori; Humans; Metronidazole; Naproxen; Omeprazole; Organometallic Compounds; Secondary Prevention; Tetracycline

We evaluated whether therapy designed to eradicate Helicobacter pylori infection resulted in a reduction in rebleeding in patients with peptic ulcer disease. Patients presenting because of major upper gastrointestinal hemorrhage from peptic ulcer and whose ulcers healed in a study in which they were randomized to receive ranitidine alone or triple therapy plus ranitidine were followed up regularly with endoscopy. No maintenance anti-ulcer therapy was given after ulcer healing.. Patients received ranitidine, 300 mg, or ranitidine plus triple therapy. Triple therapy consisted of tetracycline, 2 g; metronidazole, 750 mg; and bismuth subsalicylate, 5 or 8 tablets (151 mg bismuth per tablet), and was administered for the first 2 weeks of treatment; ranitidine therapy was continued until the ulcer had healed or 16 weeks had elapsed. After ulcer healing, no maintenance antiulcer therapy was given. Development of ulcer recurrence with or without recurrent upper gastrointestinal bleeding was evaluated.. Thirty-one patients with major upper gastrointestinal bleeding from peptic ulcer were studied; 17 received triple therapy and 14 ranitidine alone. Major rebleeding occurred significantly (p = 0.031) more often in those in the ranitidine group (28.6%), compared with none (0%) in the triple therapy group.. Eradication of H. pylori infection reduces the rate of ulcer recurrence and rebleeding in complicated ulcer disease.

Topics: Adult; Aged; Bismuth; Drug Therapy, Combination; Follow-Up Studies; Gastrointestinal Hemorrhage; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Organometallic Compounds; Peptic Ulcer; Prospective Studies; Ranitidine; Recurrence; Salicylates; Tetracycline

Topics: Anemia, Hypochromic; Breast Feeding; Deglutition Disorders; Female; Ferritins; Gastrointestinal Hemorrhage; Hemorrhage; Hemosiderin; Humans; Intestinal Absorption; Iron; Male; Pregnancy; Sex Factors; Syndrome; Tetracycline

A disease characterized by segments of ischaemic small intestine has been recognized in norther Thailand over the past decade. The clinical features and appearance of the diseased intestime are described. Most of the patients were treated by surgical resection of the affected bowel. The overall mortality was 14 per cent. Recently, some patients have been successfully treated by non-surgical means. The aetiology of the disease is still unknown.

Topics: Adolescent; Adult; Child; Child, Preschool; Diarrhea; Enteritis; Feces; Female; Gastrointestinal Hemorrhage; Humans; Hydrocortisone; Infant; Intestinal Mucosa; Intestine, Small; Ischemia; Male; Parasite Egg Count; Tetracycline; Thailand

Topics: Acute Kidney Injury; Adolescent; Adult; Aged; Blood Platelet Disorders; Body Temperature; Complement Fixation Tests; Disease Outbreaks; Female; Fluorescent Antibody Technique; Gastrointestinal Hemorrhage; Humans; Israel; Male; Middle Aged; Tetracycline; Ticks; Typhus, Endemic Flea-Borne; Typhus, Epidemic Louse-Borne

Topics: Acute Disease; Acute Kidney Injury; Adult; Chronic Disease; Creatinine; Diet Therapy; Dietary Proteins; Female; Fever; Gastrointestinal Hemorrhage; Humans; Kidney Failure, Chronic; Lupus Erythematosus, Systemic; Male; Middle Aged; Peritoneal Dialysis; Pneumonia; Prednisone; Tetracycline; Urea; Uremia

Topics: Aged; Anti-Bacterial Agents; Chloramphenicol; Female; Gastrointestinal Hemorrhage; Humans; Hypoprothrombinemias; Male; Middle Aged; Penicillin G Procaine; Tetracycline; Vitamin K

Topics: Adolescent; Chlorpheniramine; Dexamethasone; Diphenhydramine; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Humans; Hydrocortisone; Male; Methoxamine; Necrosis; Norepinephrine; Pentobarbital; Purpura; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Dogs; Gastrointestinal Hemorrhage; Hemorrhage; Hypothermia; Hypothermia, Induced; Mortality; Neomycin; Pancreatic Juice; Pancreatitis; Propylthiouracil; Research; Tetracycline

Topics: Gastrointestinal Hemorrhage; Hematemesis; Hematuria; Hepatitis; Hepatitis A; Humans; Liver Diseases; Melena; Nephritis; Tetracycline

Topics: Alkaline Phosphatase; Animals; Aspartate Aminotransferases; Bilirubin; Blood; Blood Chemical Analysis; Dogs; Gastrointestinal Hemorrhage; Gastrointestinal Tract; Hemorrhage; Liver; Nitrogen; Research; Tetracycline; Urea

Topics: Anti-Bacterial Agents; Candidiasis; Chloramphenicol; Colistin; Colitis, Ulcerative; Erythromycin; Escherichia coli Infections; Gastrointestinal Hemorrhage; Humans; Intestines; Penicillins; Peptic Ulcer Perforation; Polyps; Proteus Infections; Staphylococcal Infections; Streptomycin; Tetracycline