Cho Seong Hyun, Park Moon Sik, Park Seon-Young, Kim Dong Hyun, You Hye-Su, Kim Hyun-Soo
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
Front Med (Lausanne). 2023 Mar 22;10:1150396. doi: 10.3389/fmed.2023.1150396. eCollection 2023.
Tailored therapy has been widely used for patients with () infection in South Korea. Herein, we evaluated the treatment outcomes of tailored clarithromycin-based triple therapy (TT) in patients infected with .
We enrolled 460 patients without A2142G and A2143G point mutations by dual priming oligonucleotide-based polymerase chain reaction who had taken TT and undergone the urease breath test to evaluate eradication in clinical practice. Eradication rates according to the treatment duration and dose of clarithromycin were analyzed.
Among 460 patients (164 women, median age 63.0 years), 250 patients underwent TT with full-dose clarithromycin (TT-full CLA), and 216 patients underwent TT with half-dose clarithromycin (TT-half CLA). The eradication rates were 88.0% (220/250) in patients with TT-full CLA and 85.2% (179/210) in patients with TT-half CLA. In 250 patients with TT-full CLA, the eradication rates were 86.8% (33/38) in patients with 7-day TT-full CLA and 88.2% (187/212) in patients with 10-day or 14-day TT-full CLA ( = 0.788). In 210 patients with TT-half CLA, the eradication rates were 84.2% (139/165) in those with a 7-day TT-half CLA and 88.9% (40/45) in those with a 10-day or 14-day TT-half CLA ( = 0.436).
For patients with infection without A2142G and A2143G point mutations by DPO-PCR in clinical practice, treatment extension above 7-day TT with full CLA did not improve the eradication rates. Future studies on the treatment outcomes of TT-half CLA considering effectiveness and compliance are warranted.
在韩国，个体化治疗已广泛应用于感染（）的患者。在此，我们评估了基于克拉霉素的个体化三联疗法（TT）对感染（）患者的治疗效果。
我们纳入了460例通过基于双引物寡核苷酸的聚合酶链反应检测无A2142G和A2143G点突变、接受过TT治疗并进行了尿素呼气试验以评估根除情况的患者，这些患者均来自临床实践。分析了根据克拉霉素治疗持续时间和剂量的根除率。
在460例患者（164例女性，中位年龄63.0岁）中，250例患者接受了全剂量克拉霉素的TT治疗（TT-全剂量克拉霉素组），216例患者接受了半剂量克拉霉素的TT治疗（TT-半剂量克拉霉素组）。TT-全剂量克拉霉素组患者的根除率为88.0%（220/250），TT-半剂量克拉霉素组患者的根除率为85.2%（179/210）。在250例TT-全剂量克拉霉素组患者中，7天TT-全剂量克拉霉素组患者的根除率为86.8%（33/38），10天或14天TT-全剂量克拉霉素组患者的根除率为88.2%（187/212）（P = 0.788）。在210例TT-半剂量克拉霉素组患者中，7天TT-半剂量克拉霉素组患者的根除率为84.2%（139/165），10天或14天TT-半剂量克拉霉素组患者的根除率为88.9%（40/45）（P = 0.436）。
在临床实践中，对于通过DPO-PCR检测无A2142G和A2143G点突变的感染患者，全剂量克拉霉素超过7天的TT治疗延长并未提高根除率。有必要进一步开展关于TT-半剂量克拉霉素治疗效果及依从性的研究。
