Kang Seokin, Kim Yuri, Ahn Ji Yong, Jung Hwoon-Yong, Kim Nayoung, Na Hee Kyong, Lee Jeong Hoon, Jung Kee Wook, Kim Do Hoon, Choi Kee Don, Song Ho June, Lee Gin Hyug
Asan Medical Center, Department of Gastroenterology, University of Ulsan College of Medicine, Seoul 05505, Korea.
Asan Medical Center, Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Seoul 05505, Korea.
Antibiotics (Basel). 2021 Feb 21;10(2):214. doi: 10.3390/antibiotics10020214.
Checking susceptibility tests in the clinical setting before first-line treatment is considered difficult. We compared susceptibility-guided therapy (SGT) with empirical therapy (ET) as a first-line treatment containing clarithromycin and investigated the eradication rate using antimicrobial susceptibility testing (AST).
257 patients with infection, with AST, performed before the eradication of clarithromycin-containing regimens were enrolled and divided into two groups: the SGT and ET groups.
Eradication rates in the SGT and ET groups were 85.4% and 58.4% ( < 0.01), respectively. In triple therapy (TT), eradication rates of the SGT and ET groups were 85.1% and 56.6% ( < 0.01), respectively. In sequential therapy (SET), eradication rates of the SGT and ET groups were 86.2% and 65.6% ( = 0.06), respectively. According to AST, TT had an eradication rate of 84.6% with strains susceptible to clarithromycin and amoxicillin and 11.1% with strains resistant to both. SET had an eradication rate of 89.5% with strains susceptible to clarithromycin, amoxicillin, and metronidazole, whereas it was 0% with strains resistant to clarithromycin and metronidazole.
SGT as first-line treatment improved eradication rates of TT and SET by 28.5 ( < 0.01) and 20.6 ( = 0.06) percent points, respectively, compared with ET.
在临床环境中，在一线治疗前进行药敏试验被认为很困难。我们将药敏指导治疗（SGT）与经验性治疗（ET）作为含克拉霉素的一线治疗进行了比较，并使用抗菌药敏试验（AST）研究了根除率。
纳入257例在根除含克拉霉素方案之前进行了AST的感染患者，并将其分为两组：SGT组和ET组。
SGT组和ET组的根除率分别为85.4%和58.4%（P<0.01）。在三联疗法（TT）中，SGT组和ET组的根除率分别为85.1%和56.6%（P<0.01）。在序贯疗法（SET）中，SGT组和ET组的根除率分别为86.2%和65.6%（P = 0.06）。根据AST，对于对克拉霉素和阿莫西林敏感的菌株，TT的根除率为84.6%，而对两者均耐药的菌株的根除率为11.1%。对于对克拉霉素、阿莫西林和甲硝唑敏感的菌株，SET的根除率为89.5%，而对克拉霉素和甲硝唑耐药的菌株的根除率为0%。
与ET相比，作为一线治疗的SGT分别使TT和SET的根除率提高了28.5个百分点（P<0.01）和20.6个百分点（P = 0.06）。
