Comparison of Second-Line Quadruple Therapies with or without Bismuth for Helicobacter pylori Infection

被引:18
作者
Jheng, Guang-Hong [1 ,2 ]
Wu, I-Chen [3 ,4 ,5 ]
Shih, Hsiang-Yao [6 ]
Wu, Meng-Chieh [6 ]
Kuo, Fu-Chen [7 ]
Hu, Huang-Ming [3 ,4 ,5 ]
Liu, Chung-Jung [3 ,5 ]
Hsu, Wen-Hung [3 ,4 ,5 ]
Hu, Chi-Tan [8 ,9 ]
Bair, Ming-Jong [10 ]
Kuo, Chao-Hung [3 ,4 ,5 ,11 ]
Wu, Deng-Chyang [3 ,4 ,5 ,12 ]
Hsu, Ping-, I [13 ]
机构
[1] Kaohsiung Med Univ, Grad Inst Clin Med, Kaohsiung 807, Taiwan
[2] Kaohsiung Municipal United Hosp, Dept Internal Med, Kaohsiung 804, Taiwan
[3] Kaohsiung Med Univ Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 807, Taiwan
[4] Kaohsiung Med Univ, Coll Med, Fac Med, Dept Med, Kaohsiung 807, Taiwan
[5] Kaohsiung Med Univ, Ctr Stem Cell Res, Kaohsiung 807, Taiwan
[6] Kaohsiung Municipal Hsiaokang Hosp, Dept Internal Med, Kaohsiung 812, Taiwan
[7] I Shou Univ, E Da Hosp, Coll Med, Sch Med, Kaohsiung 824, Taiwan
[8] Tzu Chi Univ, Div Gastroenterol, Dept Internal Med, Buddhist Tzu Chi Gen Hosp, Hualien 970, Taiwan
[9] Tzu Chi Univ, Sch Med, Hualien 970, Taiwan
[10] Mackay Mem Hosp, Dept Internal Med, Div Gastroenterol, Taitung Branch, Taitung City 950, Taiwan
[11] Kaohsiung Municipal Cijin Hosp, Dept Internal Med, Kaohsiung 812, Taiwan
[12] Kaohsiung Med Univ, Ctr Infect Dis & Canc Res, Kaohsiung 807, Taiwan
[13] Natl Yang Ming Univ, Dept Internal Med, Div Gastroenterol, Kaohsiung Vet Gen Hosp, Kaohsiung 813, Taiwan
关键词
PROTON PUMP INHIBITOR; TRIPLE THERAPY; CONCOMITANT THERAPIES; ANTIBIOTIC-RESISTANCE; ERADICATION RATE; 7-DAY TRIPLE; METRONIDAZOLE; LEVOFLOXACIN; AMOXICILLIN; CLARITHROMYCIN;
D O I
10.1155/2015/163960
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
The bismuth-based quadruple regimen has been applied in Helicobacter pylori rescue therapy worldwide. The non-bismuth-based quadruple therapy or "concomitant therapy" is an alternative option in first-line eradication but has not been used in second-line therapy. Discovering a valid regimen for rescue therapy in bismuth-unavailable countries is important. We conducted a randomized controlled trial to compare the efficacies of the standard quadruple therapy and a modified concomitant regimen. One hundred and twenty-four patients were randomly assigned into two groups: RBTM (rabeprozole 20mg bid., bismuth subcitrate 120mg qid, tetracycline 500 mg qid, and metronidazole 250 mg qid) and RATM (rabeprozole 20mg bid., amoxicillin 1 g bid., tetracycline 500 mg qid, and metronidazole 250 mg qid) for 10 days. The eradication rate of the RBTM and RATM regimen was 92.1% and 90.2%, respectively, in intention-to-treat analysis. Patients in both groups had good compliance (similar to 96%). The overall incidence of adverse events was higher in the RATM group (42.6% versus 22.2%, P = 0.02), but only seven patients (11.5%) experienced grades 2-3 events. In conclusion, both regimens had good efficacy, compliance, and acceptable side effects. The 10-day RATM treatment could be an alternative rescue therapy in bismuth-unavailable countries.
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