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基于环丙沙星的三联疗法与传统三联方案根除儿童幽门螺杆菌的比较

Comparison of Ciprofloxacin-Based Triple Therapy with Conventional Triple Regimen for Helicobacter pylori Eradication in Children.

作者信息

Farahmand Fatemeh, Mohammadi Tayebeh, Najafi Mehri, Fallahi Gholamhosein, Khodadad Ahmad, Motamed Farzaneh, Mahdi Marashi Sayed, Shoaran Maryam, Nabavizadeh Rafsanjani Raheleh

机构信息

Department of Pediatric Gastroenterology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Pediatrics, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Acta Med Iran. 2016 Jun;54(6):395-400.

Abstract

Helicobacter pylori infection is a prevalent disease among Iranian children. The purpose of this study was to compare the effect of ciprofloxacin and furazolidone on eradicating helicobacter pylori in Iranian children in combination with amoxicillin and omeprazole. In this cohort study, helicobacter pylori infection was confirmed by gastroscopy, rapid urease test or pathologic assessments. A total of 66 children were randomly enrolled; based on the random number table, and were divided into two groups; first, a combination regimen consisting of ciprofloxacin, amoxicillin, and omeprazole; second, a three-medication regimen consisting of amoxicillin, furazolidone, and omeprazole. The effect of both medical regimens on the successful eradication of helicobacter pylori infection was assessed and compared. Chi-square test was used for evaluating the association between quantitative variables. All comparisons were made at the significance of P<0.05. Endoscopic tests prior to initiating treatments showed that 66.7% of the patients had a degree of nodularity while peptic ulcer was only observed in one patient. One month after the end of the treatments, eradication of the helicobacter pylori infection was reported 87.9% (29/33) in the first group (CAO) and 60.6% (20.33) in the second group (FAO) (P=0.011). It appears that a major advantage of our proposed regimen over others is a lack of wide use of fluoroquinolones for treating children's diseases. Given FDA's recommendation about the possibility of prescribing ciprofloxacin for infected patients with multidrug resistance, we can use the regimen proposed in this study in patients with resistance to standard treatments.

摘要

幽门螺杆菌感染在伊朗儿童中是一种常见疾病。本研究的目的是比较环丙沙星和呋喃唑酮联合阿莫西林和奥美拉唑对根除伊朗儿童幽门螺杆菌的效果。在这项队列研究中,通过胃镜检查、快速尿素酶试验或病理评估确诊幽门螺杆菌感染。总共随机招募了66名儿童;根据随机数字表,将他们分为两组;第一组,采用由环丙沙星、阿莫西林和奥美拉唑组成的联合治疗方案;第二组,采用由阿莫西林、呋喃唑酮和奥美拉唑组成的三联治疗方案。评估并比较了两种治疗方案对成功根除幽门螺杆菌感染的效果。采用卡方检验评估定量变量之间的关联。所有比较均在P<0.05的显著性水平下进行。治疗开始前的内镜检查显示,66.7%的患者有一定程度的结节,而仅在一名患者中观察到消化性溃疡。治疗结束后1个月,第一组(CAO)报告幽门螺杆菌感染根除率为87.9%(29/33),第二组(FAO)为60.6%(20/33)(P=0.011)。我们提出的治疗方案相对于其他方案的一个主要优势似乎是氟喹诺酮类药物在儿童疾病治疗中未被广泛使用。鉴于美国食品药品监督管理局(FDA)关于对多重耐药感染患者开具环丙沙星的可能性的建议,我们可以将本研究中提出的治疗方案用于对标准治疗耐药的患者。

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