Kwon Soohoon, Lee Dong Ho, Kang Jae Bin, Kim Nayoung, Park Young Soo, Shin Cheol Min, Yoon Hyuk, Choi Yoon Jin
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2017 Aug 25;70(2):72-80. doi: 10.4166/kjg.2017.70.2.72.
BACKGROUND/AIMS: Hybrid therapy was successful in eradicating () according to previous reports. However, to the best of our knowledge, there have only been a few studies evaluating the optimal choice after hybrid failure. Hence, we aimed to evaluate the efficacy of moxifloxacin-containing triple therapy after hybrid therapy failure in eradication.
Between January 2013 and March 2016, we retrospectively reviewed patients who underwent failed hybrid therapy, as first line treatment, in eradicating (rabeprazole and amoxicillin b.i.d for 14 days, in addition to clarithromycin and metronidazole b.i.d for final 7 days). Then, we investigated the eradication rates of moxifloxacin-containing triple therapy (rabeprazole, amoxicillin b.i.d and moxifloxacin qd) as the second line of treatment. Intention-to-treat (ITT) and per-protocol (PP) analyses were used to determine the eradication rate. We evaluated the status of by using C-urea breath test 6 weeks after the final treatment. Moreover, compliance and adverse effects of each patient were analyzed.
Among those who failed the initial hybrid therapy, 11 patients received moxifloxacin-containing triple therapy. The overall eradication rates, as determined by ITT and PP, were 72.7% (n=8/11) and 80% (n=8/10), respectively. The compliance rate was 100%, and there were no serious adverse effects.
Moxifloxacin-containing triple therapy can be used as a second line therapy in case of hybrid therapy failure. A large scale study is necessary to confirm the findings of this study and establish clinical evidence.
背景/目的:根据既往报道,联合疗法在根除(幽门螺杆菌)方面取得了成功。然而,据我们所知,仅有少数研究评估联合疗法失败后的最佳选择。因此,我们旨在评估联合疗法失败后含莫西沙星的三联疗法在根除(幽门螺杆菌)方面的疗效。
2013年1月至2016年3月期间,我们回顾性分析了作为一线治疗接受联合疗法失败的患者(雷贝拉唑和阿莫西林每日2次,共14天,外加克拉霉素和甲硝唑在最后7天每日2次)。然后,我们研究了含莫西沙星的三联疗法(雷贝拉唑、阿莫西林每日2次和莫西沙星每日1次)作为二线治疗的根除率。采用意向性分析(ITT)和符合方案分析(PP)来确定根除率。在最后一次治疗6周后,我们使用碳-尿素呼气试验评估(幽门螺杆菌)的状态。此外,分析了每位患者的依从性和不良反应。
在初始联合疗法失败的患者中,11例接受了含莫西沙星的三联疗法。由ITT和PP确定的总体根除率分别为72.7%(n = 8/11)和80%(n = 8/10)。依从率为100%,且无严重不良反应。
联合疗法失败时,含莫西沙星的三联疗法可作为二线治疗。需要进行大规模研究以证实本研究结果并确立临床证据。