Yang Qinyu, He Cong, Hu Yi, Hong Junbo, Zhu Zhenhua, Xie Yong, Shu Xu, Lu Nonghua, Zhu Yin
Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Front Pharmacol. 2023 Feb 1;14:1096103. doi: 10.3389/fphar.2023.1096103. eCollection 2023.
Currently, the management of (ri) infection in elderly patients is controversial. We investigated whether high-dose dual therapy would serve as the first-line therapy in elderly patients. This was a single-center, randomized study of 150 elderly patients with infection who were randomly assigned to 14-day therapy with pantoprazole 40 mg 3 times daily and either amoxicillin 1,000 mg 3 times daily or amoxicillin 1,000 mg twice daily, clarithromycin 500 mg twice daily and bismuth 220 mg twice daily. eradication was evaluated by a 13C-urea breath test 4 weeks after the completion of treatment. Successful eradication was achieved in 89.3% of the high-dose dual therapy (HT) group in the intention-to-treat (ITT) analysis, 91.7% in the modified intention-to-treat (mITT) analysis, and 93.0% for per-protocol (PP) analysis which was similar to the bismuth-containing quadruple therapy (BQT) group (86.6%, 87.8%, and 90.3%, respectively). There were no significant difference between the HT group and the BQT group in the ITT analysis ( = 0.484), mITT analysis ( = 0.458), or PP analysis ( = 0.403). HT was associated with fewer side effects (10.6% of patients) than BQT (26.6%) ( = 0.026). In this trial, we found that 14-day HT had a similar eradication rate to BQT but fewer side effects, which may be better for elderly patients.
目前，老年患者（ri）感染的管理存在争议。我们研究了高剂量双联疗法是否可作为老年患者的一线治疗方法。这是一项单中心、随机研究，纳入了150例（ri）感染的老年患者，他们被随机分配接受为期14天的治疗，治疗方案为每日3次服用40毫克泮托拉唑，同时每日3次服用1000毫克阿莫西林或每日2次服用1000毫克阿莫西林、每日2次服用500毫克克拉霉素以及每日2次服用220毫克铋剂。治疗完成4周后，通过13C - 尿素呼气试验评估（ri）根除情况。在意向性分析（ITT）中，高剂量双联疗法（HT）组的成功根除率为89.3%，改良意向性分析（mITT）中为91.7%，符合方案分析（PP）中为93.0%，这与含铋四联疗法（BQT）组（分别为86.6%、87.8%和90.3%）相似。在ITT分析（P = 0.484）、mITT分析（P = 0.458）或PP分析（P = 0.403）中，HT组和BQT组之间均无显著差异。与BQT（26.6%）相比，HT的副作用较少（患者的10.6%）（P = 0.026）。在本试验中，我们发现14天的HT根除率与BQT相似，但副作用更少，这可能对老年患者更好。
