Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.
Gastroenterology Institute of Jiangxi Province, Nanchang, Jiangxi Province, China.
Helicobacter. 2019 Aug;24(4):e12591. doi: 10.1111/hel.12591. Epub 2019 May 20.
BACKGROUND & AIMS: The eradication rate of Helicobacter pylori (H pylori) has decreased largely because of the antibiotic resistance. We aimed to evaluate the effectiveness and safety of furazolidone-containing quadruple regimens for H pylori eradication.
This was an observational study of furazolidone-containing quadruple regimens for H pylori infection in real-world settings. Data sets were collected from the medical records and telephone interviews of patients referred to a specialist clinic for suspected H pylori reinfection from January 1, 2015, to January 1, 2018, at the First Affiliated Hospital of Nanchang University. Main outcome measures were the eradication rate and adverse reactions during medication.
Among 584 patients with H pylori infection that met the inclusion criteria, 561 (96.1%) were treated for the first time, 19 (3.3%) had one, and 4 (0.5%) had two or more prior to furazolidone-containing quadruple regimens. The eradication rates for 10-day and 14-day regimens were 93.7% (95% CI: 91.5%-95.9%) vs 98.2% (95% CI: 95.6%-99.3%), respectively (P = 0.098). Adverse drug reactions occurred in 8.2% (48/584) with abdominal discomfort being the most common symptom. Overall adverse events with 10-day regimens were lower than 14-day regimens (6.1% vs 17.4%, P < 0.001). Logistic regression analysis indicated that poor adherence (adjusted odds ratio [AOR] = 46.5, 95% CI: 9.7-222.4) was correlated with failed eradication. Adverse drug reactions during medication were related to smoking and tobacco status, alcohol intake history, regimens combined with tetracycline, and poor adherence (all P < 0.05).
Furazolidone-containing quadruple regimens proved both safe and highly effective in a real-world setting.
由于抗生素耐药性,幽门螺杆菌(H.pylori)的根除率大大降低。我们旨在评估含呋喃唑酮的四联方案治疗 H.pylori 感染的有效性和安全性。
这是一项在真实环境中使用含呋喃唑酮的四联方案治疗 H.pylori 感染的观察性研究。数据来自 2015 年 1 月 1 日至 2018 年 1 月 1 日南昌大学第一附属医院因疑似 H.pylori 再感染而转介至专家诊所的患者的病历和电话访谈。主要观察指标是药物治疗期间的根除率和不良反应。
在符合纳入标准的 584 例 H.pylori 感染患者中,561 例(96.1%)为首次治疗,19 例(3.3%)为单次治疗,4 例(0.5%)为含呋喃唑酮四联方案前有两次或两次以上治疗。10 天和 14 天方案的根除率分别为 93.7%(95%CI:91.5%-95.9%)和 98.2%(95%CI:95.6%-99.3%)(P=0.098)。不良反应发生率为 8.2%(48/584),以腹部不适最常见。10 天方案的总不良反应发生率低于 14 天方案(6.1%比 17.4%,P<0.001)。Logistic 回归分析表明,治疗依从性差(调整后的优势比[OR]46.5,95%CI:9.7-222.4)与根除失败相关。药物治疗期间的不良反应与吸烟和烟草状况、饮酒史、联合使用四环素的方案以及治疗依从性差有关(均 P<0.05)。
在真实环境中,含呋喃唑酮的四联方案既安全又有效。