College of Medicine, Gachon University Graduate School of Medicine, Incheon 21936, South Korea.
Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea.
World J Gastroenterol. 2019 Dec 14;25(46):6790-6798. doi: 10.3748/wjg.v25.i46.6790.
Increasing levels of antibiotic resistance have reduced the () eradication rates afforded by the standard triple therapy. Thus, 2-wk first-line four-drug regimens must be considered.
To analyze the eradication rates of modified bismuth-containing quadruple therapy (mBCQT) and concomitant therapy (CT), the associated adverse events, and compliance.
Patients infected with were prospectively randomized to receive mBCQT or CT for 2 wk. mBCQT featured a proton pump inhibitor (PPI), bismuth, metronidazole, and tetracycline, taken twice daily. CT included a PPI, clarithromycin, metronidazole, and amoxicillin, taken twice daily. The C-urea breath test was performed no earlier than 4 wk after therapy concluded to confirm eradication. If either the histological or rapid urease test was positive, infection was diagnosed.
The demographic characteristics of 68 patients who received mBCQT and 68 who received CT did not differ significantly. On intention-to-treat analysis, the eradication rate was 88.2% (60/68) in the mBCQT group and 79.4% (54/68) in the CT group ( = 0.162). By per-protocol analysis, the respective eradication rates were 98.4% (60/61) and 93.1% (54/58) ( = 0.199). More CT than mBCQT patients experienced adverse events [33.8% (23/68) mBCQT 51.5% (35/58) CT patients, respectively, = 0.037]. All patients showed good compliance [85.3% (58/68) mBCQT 82.4% (56/68) CT patients, = 0.641].
The eradication rates of the 2-wk mBCQT and CT regimens are high. Most patients show good compliance, and more CT than mBCQT patients experience adverse events.
抗生素耐药性水平的升高降低了标准三联疗法所能达到的根除率。因此，必须考虑使用为期 2 周的一线四联药物治疗方案。
分析改良铋四联疗法（mBCQT）和伴随疗法（CT）的根除率、相关不良反应和依从性。
前瞻性随机选择感染的患者接受 mBCQT 或 CT 治疗 2 周。mBCQT 方案包括质子泵抑制剂（PPI）、铋剂、甲硝唑和四环素，每日 2 次。CT 方案包括 PPI、克拉霉素、甲硝唑和阿莫西林，每日 2 次。治疗结束后至少 4 周进行 C-尿素呼气试验以确认根除。如果组织学或快速尿素酶检测阳性，则诊断为感染。
接受 mBCQT 和 CT 的 68 例患者的人口统计学特征无显著差异。意向治疗分析显示，mBCQT 组的根除率为 88.2%（60/68），CT 组为 79.4%（54/68）（=0.162）。按方案分析，各自的根除率分别为 98.4%（60/61）和 93.1%（54/58）（=0.199）。CT 组比 mBCQT 组更多的患者出现不良反应[33.8%（23/68）mBCQT组，51.5%（35/58）CT 组，=0.037]。所有患者均具有良好的依从性[85.3%（58/68）mBCQT 组，82.4%（56/68）CT 组，=0.641]。
为期 2 周的 mBCQT 和 CT 方案的根除率均较高。大多数患者具有良好的依从性，CT 组比 mBCQT 组更多的患者出现不良反应。
