Hori Kazutoshi, Takagawa Tetsuya, Hida Nobuyuki, Nakamura Shiro
Department of Intestinal Inflammation Research, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501,Japan.
Department of Intestinal Inflammation Research, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501,Japan.
Curr Drug Saf. 2017;12(2):103-109. doi: 10.2174/1574886312666170310100209.
Standard triple therapy with the proton pump inhibitors, clarithromycin and amoxicillin for Helicobacter pylori infection is considered to be safe; however, the development of significant adverse events (AEs), such as skin rashes, has been reported.
To reconfirm the safety of this treatment.
This was a retrospective cohort study. After the exclusion of patients allergic to penicillin, 322 consecutive patients, consisting of 305 outpatients and 17 inpatients, had received the first-line eradication treatment with lansoprazole (30 mg), clarithromycin (200 mg), and amoxicillin (750 mg) twice daily for 7 days. Their medical charts were reviewed, and data were collected.
Three patients discontinued the treatment because of the development of a skin rash, mild diarrhea, and heat sensation, respectively. The main AE observed was mild diarrhea in 50 patients. One patient had frequent diarrhea, but it was readily resolved by a probiotic treatment. On the second or third day after the conclusion of the treatment, a skin rash also occurred in six patients (2%). Two of these patients and one patient who discontinued the treatment were administered steroids as outpatients. They recovered within 1 month.
Most AEs that developed were mild, except for some cases of a rash. Rashes developed in spite of the exclusion of penicillin-allergic patients and mainly after the completion of the one-week treatment. As a consequence of little previous exposure to penicillin in the Japanese population, the development of delayed rashes after this exclusion may represent first sensitization to penicillin.
质子泵抑制剂、克拉霉素和阿莫西林的标准三联疗法用于治疗幽门螺杆菌感染被认为是安全的；然而，已有报道出现严重不良事件（AE），如皮疹。
再次确认该治疗方法的安全性。
这是一项回顾性队列研究。排除对青霉素过敏的患者后，322例连续患者（包括305例门诊患者和17例住院患者）接受了一线根除治疗，使用兰索拉唑（30毫克）、克拉霉素（200毫克）和阿莫西林（750毫克），每日两次，共7天。查阅了他们的病历并收集了数据。
3例患者分别因出现皮疹、轻度腹泻和发热感而停药。观察到的主要不良事件是50例患者出现轻度腹泻。1例患者腹泻频繁，但通过益生菌治疗很快得到缓解。在治疗结束后的第二天或第三天，6例患者（2%）也出现了皮疹。其中2例患者和1例停药患者作为门诊患者接受了类固醇治疗。他们在1个月内康复。
除了一些皮疹病例外，大多数出现的不良事件是轻度的。尽管排除了青霉素过敏患者，但皮疹仍有发生，且主要在一周治疗结束后出现。由于日本人群此前很少接触青霉素，排除此类患者后出现延迟性皮疹可能代表对青霉素的初次致敏。
