Yilmaz Baris, Koseoglu Huseyin, Coskun Yusuf, Deveci Murat, Kekilli Murat
Department of Gastroenterology, Diskapi Yıldırım Beyazit Educational and Research Hospital, Ankara, Turkey.
Department of Gastroenterology, Ataturk Educational and Research Hospital, Ankara, Turkey.
Prz Gastroenterol. 2018;13(2):150-156. doi: 10.5114/pg.2018.72732. Epub 2018 Jan 22.
infection is encountered in more than 50% of the world population. A high rate of clarithromycin resistance is observed among strains in some regions because clarithromycin is a drug commonly used for the treatment of other infections.
To identify an efficient eradication protocol for patients infected with and to suggest an alternative first-line therapy particularly in countries with high clarithromycin resistance.
Patients (18-75 years old) having dyspeptic complaints in a 1-year period and diagnosed with infection by gastric biopsy were included and randomised to three groups, each receiving different sequential eradication therapy (LAM-B: lansoprazole, amoxicillin, metronidazole, bismuth: LAM-T: lansoprazole, amoxicillin, metronidazole, tetracycline; LAM-BT: lansoprazole, amoxicillin, metronidazole, bismuth, tetracycline). Eradication was evaluated via urea breath test.
This study included 166 patients (mean age: 40 ±12 years; female, 68.7%) with infection. Among them, 50 (30.1%) were in the LAM-B group, 59 (35.5%) were in the LAM-T group, and 57 (34.3%) were in the LAM-BT group. The non-steroidal anti-inflammatory drug use was the lowest in the LAM-BT group. Eradication rates were over 80% and similar in each group, with the highest rate in the LAM-BT group (93%). Adverse event rate was the highest in the LAM-T group. eradication was achieved in 143 (86.1%) patients.
The combination regimens without clarithromycin achieved an eradication rate over 80% in all groups. Knowing and monitoring the regional antibiotic resistance rates is important for successful treatment of infections.
全球超过50%的人口曾遭遇感染。在某些地区的菌株中观察到较高的克拉霉素耐药率，因为克拉霉素是常用于治疗其他感染的药物。
确定针对感染患者的有效根除方案，并提出替代一线疗法，特别是在克拉霉素耐药率高的国家。
纳入在1年期间有消化不良症状且经胃活检诊断为感染的患者（18 - 75岁），并随机分为三组，每组接受不同的序贯根除疗法（LAM - B：兰索拉唑、阿莫西林、甲硝唑、铋剂；LAM - T：兰索拉唑、阿莫西林、甲硝唑、四环素；LAM - BT：兰索拉唑、阿莫西林、甲硝唑、铋剂、四环素）。通过尿素呼气试验评估根除情况。
本研究纳入了166例感染患者（平均年龄：40±12岁；女性占68.7%）。其中，50例（30.1%）在LAM - B组，59例（35.5%）在LAM - T组，57例（34.3%）在LAM - BT组。LAM - BT组使用非甾体抗炎药的情况最少。每组的根除率均超过80%且相似，LAM - BT组的根除率最高（93%）。LAM - T组的不良事件发生率最高。143例（86.1%）患者实现了根除。
不含克拉霉素的联合方案在所有组中均实现了超过80%的根除率。了解和监测区域抗生素耐药率对于成功治疗感染很重要。
