Department of Gastroenterology, Internal Medicine Clinic, Clinical Hospital Sveti Duh, Zagreb, Croatia.
Ann Clin Microbiol Antimicrob. 2010 Apr 15;9:13. doi: 10.1186/1476-0711-9-13.
Antibiotic resistance decreases success of Helicobacter pylori (Hp) eradication. Recently published results show low rate of resistance and better compliance with moxifloxacin based regiments. AIMS&METHODS: Whether 7 days moxifloxacin with lansoprasole and amoxycillin can be compared with 10 days moxifloxacin with lansoprasole and amoxycillin according to moxifloxacin resistance. Patients with non-ulcer dyspepsia who had culture and histology positive Hp infection (n = 150) were randomly assigned into two groups. The first group (n = 75) received moxifloxacin 400 mg/d during 7 days and the other (n = 75) received moxifloxacin 400 mg/d during 10 days. All patients received amoxycillin 1 g twice daily, lansoprasole 30 mg twice daily. All Hp cultures were tested for sensitivity to moxifloxacin.
138 patients (92%) completed the study, 68 in the first group and 70 in the second. Eradication rates were 84% (57/68) and 76% (57/75) in the 7 days moxifloxacin group and 90% and 84% in the second group (63/70, 63/75) according to the PP and ITT analysis; p = n.s. Among 129 patients (86% of study group), 6% of strains were primary resistant to moxifloxacin. Eradication of moxifloxacin sensitive/resistant strains was 98%/66%, p < 0.05.
According to our results we recommend 7 days moxiflixacin based triple therapy.
抗生素耐药性降低了幽门螺杆菌 (Hp) 根除的成功率。最近发表的结果表明,莫西沙星为基础的方案耐药率较低,且患者顺应性更好。
根据莫西沙星耐药性,7 天莫西沙星联合兰索拉唑和阿莫西林能否与 10 天莫西沙星联合兰索拉唑和阿莫西林相媲美。患有非溃疡性消化不良且 Hp 感染培养和组织学阳性的患者(n=150)被随机分为两组。第一组(n=75)接受莫西沙星 400mg/d 治疗 7 天,另一组(n=75)接受莫西沙星 400mg/d 治疗 10 天。所有患者均接受阿莫西林 1g 每日 2 次,兰索拉唑 30mg 每日 2 次。所有 Hp 培养物均进行莫西沙星敏感性检测。
138 例患者(92%)完成了研究,第一组 68 例,第二组 70 例。7 天莫西沙星组的根除率分别为 84%(57/68)和 76%(57/75),根据 PP 和 ITT 分析,第二组分别为 90%和 84%(63/70,63/75);p=n.s.。在 129 例患者(研究组的 86%)中,有 6%的菌株对莫西沙星呈原发性耐药。莫西沙星敏感/耐药菌株的根除率分别为 98%和 66%,p<0.05。
根据我们的结果,我们推荐使用 7 天莫西沙星三联疗法。