Ibrahim Nour, El Said Hassan, Choukair Ali
Faculty of Medical Sciences, Lebanese University, Beirut 0000, Lebanon.
Department of Biological and Chemical Sciences, School of Arts and Sciences, Lebanese International University, Beirut 0000, Lebanon.
World J Clin Cases. 2022 Jan 7;10(1):227-235. doi: 10.12998/wjcc.v10.i1.227.
() infection is a worldwide problem with increasing burden on the health sector due to its increasing rate of resistance. The conventional triple therapy (TT) is becoming obsolete with a high failure rate of eradication, necessitating the need for better alternatives or regimens.
To investigate eradication rate of TT modified bismuth quadruple therapy.
Ninety-two patients with dyspepsia symptoms and positive C-urea breath test were randomly assigned to two groups. The first group (control group) was treated for 14 d using standard TT protocol: Esomeprazole (40 mg twice daily), amoxicillin (1 g twice daily) and clarithromycin (500 mg twice daily). On the other hand, the second group was prescribed a 10-d course of modified bismuth quadruple therapy fortified with zinc carnosine: TT in addition to bismuth subcitrate (240 mg twice daily) and zinc carnosine (75 mg twice daily). A repeated C-urea breath test was done 4 wk after the completion of the eradication therapy.
Among the 92 subjects, 67.4% were males and 32.6% were females. There were no differences in demographic characteristics (age, body mass index, smoking history, previous antibiotics use and ethnicity) between the modified bismuth quadruple therapy group and TT group. The eradication rate was higher [93.5% (43/46)] in the modified bismuth quadruple therapy group compared to 69.6% (32/46) in the standard TT group ( = 0.003). Of the tested predictor variables, only nationality, smoking and therapy type were statistically significant. Besides dizziness, which was recorded in modified bismuth quadruple therapy group, there were no significant differences in side effects between the two groups.
Ten days of modified bismuth quadruple therapy fortified with zinc carnosine is superior to 14 d of conventional TT in eradicating infection, with no additional significant adverse events.
（）感染是一个全球性问题，由于其耐药率不断上升，给卫生部门带来的负担日益加重。传统的三联疗法（TT）因根除失败率高而逐渐过时，因此需要更好的替代方案或治疗方案。
研究三联疗法与改良铋剂四联疗法的根除率。
92例有消化不良症状且C-尿素呼气试验阳性的患者被随机分为两组。第一组（对照组）采用标准三联疗法治疗14天：埃索美拉唑（40mg，每日两次）、阿莫西林（1g，每日两次）和克拉霉素（500mg，每日两次）。另一方面，第二组采用含肌肽锌强化的改良铋剂四联疗法，疗程为10天：三联疗法加次枸橼酸铋（240mg，每日两次）和肌肽锌（75mg，每日两次）。根除治疗完成4周后进行重复C-尿素呼气试验。
92名受试者中，男性占67.4%，女性占32.6%。改良铋剂四联疗法组和三联疗法组在人口统计学特征（年龄、体重指数、吸烟史、既往抗生素使用情况和种族）上无差异。改良铋剂四联疗法组的根除率[93.5%（43/46）]高于标准三联疗法组的69.6%（32/46）（P = 0.003）。在测试的预测变量中，只有国籍、吸烟和治疗类型具有统计学意义。除改良铋剂四联疗法组记录的头晕外，两组副作用无显著差异。
含肌肽锌的改良铋剂四联疗法治疗10天在根除（）感染方面优于传统三联疗法治疗14天，且无额外的显著不良事件。
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