tetracycline and Peptic-Ulcer-Perforation

The possible advantage of eradication of Helicobacter pylori in patients with perforated duodenal ulcer is unknown. This study was planned to assess the prevalence of H. pylori after simple closure of a perforated duodenal ulcer and to study the effect of H. pylori eradication on ulcer persistence and recurrence.. Some 202 patients were followed prospectively for 2 years after simple closure of a perforated duodenal ulcer (prospective group). A second group of 60 patients was reviewed 5 years or more after perforation closure (retrospective group). The prevalence of H. pylori in patients with perforated duodenal ulcer was compared with that in controls. Patients in the prospective group were randomized to receive either ranitidine alone or quadruple therapy (ranitidine, colloidal bismuth subcitrate, metronidazole and tetracycline) after operation. The incidence of H. pylori infection after the two treatments and the association with residual or recurrent ulcer were studied. In the retrospective group long-term ulcer recurrence was correlated with H. pylori status.. The prevalence of H. pylori in patients with perforated duodenal ulcer was not significantly different from that in controls. At every interval of follow-up in the prospective group and in the retrospective group the H. pylori infection rate was significantly higher in patients who had recurrent or residual ulcers.. Eradication of H. pylori after simple closure of a perforated duodenal ulcer should reduce the incidence of residual and recurrent ulcers.

Topics: Adolescent; Adult; Aged; Antacids; Anti-Bacterial Agents; Anti-Ulcer Agents; Bismuth; Duodenal Ulcer; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Peptic Ulcer Perforation; Prospective Studies; Ranitidine; Recurrence; Retrospective Studies; Tetracycline

Topics: Amoxicillin; Antacids; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Ulcer Agents; Clarithromycin; Drug Therapy, Combination; Follow-Up Studies; Helicobacter Infections; Helicobacter pylori; Humans; Incidence; Metronidazole; Omeprazole; Organometallic Compounds; Peptic Ulcer Perforation; Randomized Controlled Trials as Topic; Recurrence; Tetracycline; Time Factors

Topics: Aprotinin; Chloramphenicol; Drainage; Duodenal Ulcer; Female; Humans; Italy; Male; Peptic Ulcer Perforation; Peritoneal Cavity; Postoperative Complications; Stomach Ulcer; Suture Techniques; Tetracycline

Topics: Actinomycosis; Adolescent; Anti-Bacterial Agents; Appendicitis; Duodenal Ulcer; Gastrectomy; Humans; Intraabdominal Infections; Penicillins; Peptic Ulcer Perforation; Tetracycline

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Antibiotics, Antitubercular; Belgium; Celiac Disease; Chloramphenicol; Dermatologic Agents; Geriatrics; Humans; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Peptic Ulcer Perforation; Sarcoma; Sprue, Tropical; Steatorrhea; Tetracycline

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