Gao Chun, Fan Yan-Hua
Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, 100029, People's Republic of China.
Infect Drug Resist. 2022 Jun 22;15:3277-3286. doi: 10.2147/IDR.S371113. eCollection 2022.
The elderly people generally have poor tolerance to drugs and an increased risk of adverse effects. Our study was designed to determine the effect and safety of () eradication treatment based on molecular pathologic antibiotic resistance in Chinese elderly people over the age of 60 years.
A total of 364 people were retrospectively analyzed, including 113 older people over 60 and 251 young and middle-aged people in the age of 20-59 years. Real-time PCR detection and conventional PCR and sequencing method were used for drug susceptibility testing. As the main outcome measure, the eradication rates (ERs) with their 95% confidence intervals (CIs) were analyzed by intention to treat (ITT) and per protocol (PP). For the safety of therapy, adverse events were analyzed.
For the total people, the resistance rates to clarithromycin (CLR), amoxicillin (AMX), fluoroquinolone (FLQ) and tetracycline (TET) were 65.06%, 7.54%, 61.39% and 20.37%, respectively. After they were divided into two groups, the resistance rates were 62.39% (CLR), 9.09% (AMX), 69.64% (FLQ) and 22.45% (TET) in the 113 older people over 60, and 66.26%, 6.85%, 57.66% and 19.47% in the 251 young and middle-aged people in 20-59. By the ITT analysis, the ERs were 92.04% (95% CI, 86.97-97.10%, n=113) in the older people and 92.43% (95% CI, 89.14-95.73%, n=251) in the young and middle-aged people. By the PP analysis, the ERs were 96.30% (95% CI, 92.68-99.92%, n=108) and 94.69% (95% CI, 91.87-97.52%, n=245), respectively. No significant differences were shown both in the ITT analysis (P=0.896) and in the PP analysis (P=0.517). The three most common adverse events were black stool, dysgeusia and diarrhea, and no serious adverse event was reported.
eradication treatment based on molecular pathologic antibiotic resistance showed good effect and safety in Chinese elderly people.
老年人通常对药物耐受性差，不良反应风险增加。我们的研究旨在确定基于分子病理抗生素耐药性的（）根除治疗对60岁以上中国老年人的疗效和安全性。
回顾性分析364人，其中包括113名60岁以上老年人和251名20 - 59岁的中青年。采用实时荧光定量PCR检测及常规PCR和测序方法进行药敏试验。作为主要结局指标，通过意向性分析（ITT）和符合方案分析（PP）分析根除率（ERs）及其95%置信区间（CIs）。对于治疗安全性，分析不良事件。
总体人群中，对克拉霉素（CLR）、阿莫西林（AMX）、氟喹诺酮（FLQ）和四环素（TET）的耐药率分别为65.06%、7.54%、61.39%和20.37%。分为两组后，113名60岁以上老年人中对CLR、AMX、FLQ和TET的耐药率分别为62.39%、9.09%、69.64%和22.45%，251名20 - 59岁中青年中分别为66.26%、6.85%、57.66%和19.47%。通过ITT分析，老年人的根除率为92.04%（95%CI，86.97 - 97.10%，n = 113），中青年的根除率为92.43%（95%CI，89.14 - 95.73%，n = 251）。通过PP分析，根除率分别为96.30%（95%CI，92.68 - 99.92%，n = 108）和94.69%（95%CI，91.87 - 97.52%，n = 245）。ITT分析（P = 0.896）和PP分析（P = 0.517）均未显示出显著差异。三种最常见的不良事件为黑便、味觉障碍和腹泻，未报告严重不良事件。
基于分子病理抗生素耐药性的根除治疗在中国老年人中显示出良好的疗效和安全性。
