Kilic Guner, Kilic Gulce Ecem, Özkahraman Adnan, Konur Sevki, Dertli Ramazan, Kayar Yusuf
Van Training and Research Hospital, Department of Internal Medicine, Division of Gastroenterology, Van, Turkey.
Van Training and Research Hospital, Department of Internal Medicine, Van, Turkey.
Medicine (Baltimore). 2024 May 3;103(18):e38012. doi: 10.1097/MD.0000000000038012.
Success in eradication of H. pylori is decreasing due to increasing resistant strains. In particular, side-effects due to 4-agent treatment multiple drug use are observed and treatment compliance decreases. The aim of this study was to evaluate the efficacy, reliability, and side-effect profile of the combination of amoxicillin and rabeprazole with gemifloxacin, which is a new generation quinolone, in the treatment of H. pylori infection. This study was conducted on 71 naive patients who received H. pylori eradication. All the patients were administered treatment of Amoxicillin (1000 mg twice a day) + Gemifloxacin (320 mg once a day) + rabeprazole (20 mg twice a day) for 7 days. Drug compliance and treatment tolerance were evaluated after finishing the treatment. At 1 month after the end of the treatment, H. pylori eradication was evaluated in all the patients by examining H. pylori antigen in the feces. In the evaluation after treatment, H. pylori eradication was obtained in 63 (88.7%) patients and eradication was not obtained in 8 (11.3%) patients. The treatment was not completed by 2 patients because of side-effects and noncompliance, so after exclusion of these 2 patients, successful H. pylori eradication was obtained in 63 (91.3%) of 69 patients who completed the treatment. Side-effects were seen in a total of 9 (12.7%) patients. Diarrhea, bloating, abdominal pain, and nausea-vomiting were seen in some patients, but no reflux, constipation, skin rash, listlessness-fatigue, headache, dizziness, palpitations, dry mouth, or weight loss was seen in any patient. In regions with high resistance to clarithromycin and metronidazole in particular, the combination of gemifloxacin with amoxicillin and rabeprazole can be considered for use in first-stage treatment as both the efficacy and tolerability are high.
由于耐药菌株的增加，幽门螺杆菌根除治疗的成功率正在下降。特别是，观察到四联疗法多药联合使用引起的副作用，治疗依从性降低。本研究的目的是评估阿莫西林、雷贝拉唑与新一代喹诺酮类药物吉米沙星联合使用在治疗幽门螺杆菌感染中的疗效、可靠性和副作用情况。本研究对71例初治幽门螺杆菌感染患者进行。所有患者均接受阿莫西林（1000毫克，每日两次）+吉米沙星（320毫克，每日一次）+雷贝拉唑（20毫克，每日两次）治疗7天。治疗结束后评估药物依从性和治疗耐受性。治疗结束后1个月，通过检测粪便中的幽门螺杆菌抗原对所有患者进行幽门螺杆菌根除评估。治疗后评估显示，63例（88.7%）患者实现了幽门螺杆菌根除，8例（11.3%）患者未实现根除。2例患者因副作用和不依从未完成治疗，因此排除这2例患者后，69例完成治疗的患者中有63例（91.3%）成功根除幽门螺杆菌。共有9例（12.7%）患者出现副作用。部分患者出现腹泻、腹胀、腹痛和恶心呕吐，但未发现任何患者有反流、便秘、皮疹、倦怠-疲劳、头痛、头晕、心悸、口干或体重减轻。特别是在对克拉霉素和甲硝唑耐药性高的地区，吉米沙星与阿莫西林和雷贝拉唑联合使用可考虑用于一线治疗，因为其疗效和耐受性都很高。
