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高剂量频繁服用右兰索拉唑和阿莫西林联合疗法治疗幽门螺杆菌感染:一项单臂前瞻性研究。

High and Frequent Dose of Dexlansoprazole and Amoxicillin Dual Therapy for Helicobacter pylori Infections: A Single Arm Prospective Study.

作者信息

Park Hye Yoon, Kang Eun Jeong, Kim Dong Gun, Kim Ki Ju, Choi Jin Woo, Nam Su Youn, Kwon Yong Hwan, Lee Hyun Seok, Jeon Seong Woo

机构信息

Division of Gastroenterology, Department of Internal Medicine, Gastric Cancer Center, Kyungpook National University Chilgok Hospital, Daegu, Korea.

出版信息

Korean J Gastroenterol. 2017 Oct 25;70(4):176-180. doi: 10.4166/kjg.2017.70.4.176.

Abstract

BACKGROUND/AIMS: Recently, the eradication rate of () infection has decreased to less than 80% worldwide with the use of clarithromycin-based triple therapy owing to the increased resistance of to antibiotics, especially clarithromycin and metronidazole. This prospective study aimed to determine eradication rate of following high and frequent doses of extended-release dexlansoprazole and amoxicillin, as a dual therapy in a region with high clarithromycin resistance rate.

METHODS

A total of 50 treatment-naïve patients with active infections, who were confirmed through via rapid urease test or histology and serology between November 2015 and February 2016 at our hospital, were included for analysis. All enrolled patients were treated with 750 mg amoxicillin and 30 mg dexlansoprazole, four times a day for a total duration of 14 days. Treatment success was determined using urea breath test four weeks after treatment completion.

RESULTS

Seven out of the 50 patients (29 men and 21 women; mean age, 57 years) dropped out during the study. The total eradication rate was 52% (26/50), and that for those with a compliance rate of over 90% was 68.4% (26/38). infections were not successfully eradicated in patients with a compliance rate of less than 90%. Nine patients (18%) reported side effects, such as mild diarrhea and abdominal fullness. No significant factors, such as smoking and alcohol consumption, affected the infection the eradication rate.

CONCLUSIONS

High and frequent doses of proton pump inhibitor-amoxicillin dual therapy were not effective in eradicating infection in a province with high clarithromycin resistance rate.

摘要

背景/目的:近来,由于幽门螺杆菌对抗生素尤其是克拉霉素和甲硝唑的耐药性增加,在全球范围内使用以克拉霉素为基础的三联疗法时,幽门螺杆菌感染的根除率已降至80%以下。这项前瞻性研究旨在确定在克拉霉素耐药率高的地区,高剂量且频繁给药的缓释右兰索拉唑和阿莫西林作为双联疗法治疗幽门螺杆菌后的根除率。

方法

纳入我院2015年11月至2016年2月期间共50例初治的活动性幽门螺杆菌感染患者进行分析,这些患者通过快速尿素酶试验或组织学及血清学确诊。所有入选患者接受750mg阿莫西林和30mg右兰索拉唑治疗,每日4次,共14天。治疗结束4周后通过尿素呼气试验确定治疗是否成功。

结果

50例患者(29例男性和21例女性;平均年龄57岁)中有7例在研究期间退出。总根除率为52%(26/50),依从率超过90%的患者根除率为68.4%(26/38)。依从率低于90%的患者幽门螺杆菌感染未成功根除。9例患者(18%)报告有副作用,如轻度腹泻和腹胀。吸烟和饮酒等因素对感染根除率无显著影响。

结论

在克拉霉素耐药率高的省份,高剂量且频繁给药的质子泵抑制剂 - 阿莫西林双联疗法对根除幽门螺杆菌感染无效。

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