Gao W, Zheng S H, Cheng H, Wang C, Li Y X, Xu Y, Hu F L
Department of Gastroenterology, Peking University First Hospital, Beijing 100034, China.
Department of Gastroenterology, Langfang 4th People's Hospital, Langfang 067500, China.
Zhonghua Yi Xue Za Zhi. 2019 May 28;99(20):1536-1540. doi: 10.3760/cma.j.issn.0376-2491.2019.20.004.
To evaluate the efficacy and safety of tetracycline and metronidazole based quadruple regimen as first line treatment for penicillin allergic patients with () infection. The clinical data of 120 patients who had infected with and were allergic to penicillin in out-patient clinic of Peking University First Hospital was retrospectively collected from January 2014 to June 2016. The regimen included: lansoprazole 30 mg twice a day+ Bismuth 150 mg three times a day+ tetracycline 500 mg three times a day+ metronidazole 400 mg three times a day, for 14 days. All patients were followed up 7 days, 14 days, at least 4 weeks after the treatment. Symptoms and side effects were recorded. The status was evaluated by (13)C urease breath test at least 4 weeks after the end of the treatment. All patients included 86 female and 34 male, and the average age is 59 years. There are 104 of the 120 cases who got success in eradication treatment. Mild to moderate adverse effects occurred in 56 cases (46.7%). 10 female patients dropped out because of headache, rash, vomiting and fatigue. The eradication rates were 86.7% (104/120, ITT) and 94.5% (104/110, PP). Tetracycline and metronidazole based 14-day quadruple regimen is effective as first line treatment for penicillin allergic patients with infection because of its relatively high eradication rate. Patients should be watched closely during the treatment since the adverse effects of this regimen happen frequently,especially for female patients.
评估以四环素和甲硝唑为基础的四联疗法作为青霉素过敏患者感染幽门螺杆菌一线治疗方案的疗效和安全性。回顾性收集2014年1月至2016年6月北京大学第一医院门诊120例幽门螺杆菌感染且对青霉素过敏患者的临床资料。治疗方案包括:兰索拉唑30毫克,每日2次;铋剂150毫克,每日3次;四环素500毫克,每日3次;甲硝唑400毫克,每日3次,疗程14天。所有患者在治疗后7天、14天、至少4周进行随访,记录症状和副作用。治疗结束至少4周后通过(13)C尿素呼气试验评估幽门螺杆菌状态。所有患者中女性86例,男性34例,平均年龄59岁。120例中有104例根除治疗成功。56例(46.7%)出现轻至中度不良反应。10例女性患者因头痛、皮疹、呕吐和乏力退出。意向性分析(ITT)根除率为86.7%(104/120),符合方案分析(PP)根除率为94.5%(104/110)。以四环素和甲硝唑为基础的14天四联疗法作为青霉素过敏幽门螺杆菌感染患者的一线治疗方案有效,因其根除率相对较高。治疗期间应密切观察患者,因为该方案不良反应发生率高,尤其是女性患者。