Goh K, Parasakthi N, Cheah P, Ranjeev C, Rosmawati M, Tan Y, Chin S
Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
J Gastroenterol Hepatol. 2000 Aug;15(8):910-4. doi: 10.1046/j.1440-1746.2000.02229.x.
The aim of the present paper was to determine the efficacy and tolerability of a 1-week treatment regimen consisting of pantoprazole and two antibiotics: clarithromycin and amoxycillin, in the eradication of Helicobacter pylori.
The patients selected had unequivocal evidence of H. pylori infection based on urease test, culture and histology on antral and corpus biopsies obtained at endoscopy. Patients received pantoprazole 40 mg twice a day, clarithromycin 500 mg twice a day and amoxycillin 1 g twice a day for 1 week and were assessed for successful eradication at least 4 weeks after completion of therapy by repeat gastroscopy and gastric biopsies. Eradication was defined as absence of bacteria in both antral and corpus biopsies tested by culture, histology and urease test.
One hundred and six patients were recruited for the study. The mean age was 48.0 years (range: 23-74 years). Four patients defaulted follow up and five patients were not compliant (taking less than 85%) with medications. Eradication rates on per-protocol analysis were: 88/97 (90.7%; 95% CI: 83.1-95.7); and on intention-to-treat analysis they were: 88/106 (83.0%; 95% CI: 75.9-90.2). Side-effects were in general mild and tolerable: 57 of 106 (53.7%) patients complained of a bitter taste; 15 (14.1%) complained of giddiness; 10 (9.4%) complained of increased abdominal pain; 11 (11.5%) complained of lethargy and 16 (15.1%) complained of loose motions. Pre-treatment metronidazole resistance was encountered in 57/74 strains (77.0%). Clarithromycin resistance was not encountered in any of the strains.
The pantoprazole 1-week triple therapy with amoxycillin and clarithromycin is effective in H. pylori eradication. The treatment was well tolerated by patients. Metronidazole resistance was reported in a high percentage of strains isolated from patients. Clarithromycin resistance was, however, not detected in any of the strains.
本文旨在确定由泮托拉唑与两种抗生素（克拉霉素和阿莫西林）组成的1周治疗方案根除幽门螺杆菌的疗效和耐受性。
入选患者经内镜检查获取胃窦和胃体活检组织，通过尿素酶试验、培养及组织学检查有明确的幽门螺杆菌感染证据。患者接受泮托拉唑40毫克每日2次、克拉霉素500毫克每日2次和阿莫西林1克每日2次，疗程1周，治疗结束后至少4周通过重复胃镜检查和胃活检评估根除是否成功。根除定义为通过培养、组织学和尿素酶试验检测胃窦和胃体活检组织均无细菌。
106例患者纳入研究。平均年龄48.0岁（范围：23 - 74岁）。4例患者未进行随访，5例患者未按医嘱服药（服药少于85%）。符合方案分析的根除率为：88/97（90.7%；95%可信区间：83.1 - 95.7）；意向性分析的根除率为：88/106（83.0%；95%可信区间：75.9 - 90.2）。副作用总体较轻且可耐受：106例患者中有57例（53.7%）主诉口苦；15例（14.1%）主诉头晕；10例（9.4%）主诉腹痛加重；11例（11.5%）主诉乏力；16例（15.1%）主诉腹泻。74株菌株中有57株（77.0%）治疗前检测出对甲硝唑耐药。未发现任何菌株对克拉霉素耐药。
泮托拉唑联合阿莫西林和克拉霉素的1周三联疗法对根除幽门螺杆菌有效。患者对该治疗耐受性良好。从患者分离出的菌株中，有较高比例报告对甲硝唑耐药。然而，未检测到任何菌株对克拉霉素耐药。
