低剂量四环素、阿莫西林四联疗法治疗感染的疗效和安全性：一项回顾性单中心研究。

Efficacy and safety of low-dose tetracycline, amoxicillin quadruple therapy in infection: A retrospective single center study.

机构信息

Department of Gastroenterology, Sir Run Run Shaw Hospital, Medical School, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.

Department of Gastroenterology, The First Affiliated Hospital, Medical School, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.

出版信息

World J Gastroenterol. 2024 Oct 21;30(39):4295-4304. doi: 10.3748/wjg.v30.i39.4295.

DOI:10.3748/wjg.v30.i39.4295

PMID:39492823

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11525849/

Abstract

BACKGROUND

() eradication rates have declined with the rise of antibiotic-resistant strains in recent years. Although highly effective with a low prevalence of resistance, standard dose tetracycline is associated with frequent adverse events. The efficacy and safety of low-dose tetracycline as part of tetracycline and amoxicillin-containing bismuth quadruple therapy are not well described.

AIM

To compare the efficacy and safety of low-dose compared to standard dose tetracycline with combined amoxicillin-containing bismuth quadruple therapy in patients with infection.

METHODS

Consecutive patients with infection receiving tetracycline, amoxicillin, proton pump inhibitor, and bismuth for 14 days at Sir Run Run Shaw Hospital (1/2022-6/2023) were evaluated. The low-dose tetracycline group received tetracycline 500 mg twice daily (bid) while the standard dose group received 750 mg bid or 500 mg three times daily (tid). Primary endpoints were eradication rate and treatment-related adverse events.

RESULTS

The mean age of the 218 patients was 48.7 ± 14.0 years, 120 (55%) were male, and 118 (54.1%) received treatment as primary therapy. Furthermore, 73 (33%) patients received low-dose tetracycline (500 mg bid) and 145 (67%) received standard dose tetracycline including 500 mg tid in 74 (33%) and 750 mg bid in 71 (33%). On intention-to-treat analysis, eradication rates were 89% [95% confidence interval (CI): 82%-96%] in the 500 mg bid group, 82% (95%CI: 74%-91%) in the 500 mg tid group, and 79% (95%CI: 69%-89%) in the 750 mg bid group without a statistically significant difference ( = 0.25). The incidence of adverse events was lower in the low-dose compared to the standard dose group (12.3% 31.1% or 23.9%; = 0.02).

CONCLUSION

Low-dose tetracycline combined with amoxicillin quadruple therapy for 14 days achieved a high eradication rate and fewer adverse events compared to the standard dose tetracycline regimen in patients with infection.

摘要

背景

近年来，随着抗生素耐药菌株的出现，的根除率有所下降。虽然标准剂量的四环素具有很高的疗效和较低的耐药率，但它常伴有频繁的不良反应。低剂量四环素作为包含四环素和阿莫西林的铋四联疗法的一部分的疗效和安全性尚未得到充分描述。

目的

比较低剂量与标准剂量四环素联合含阿莫西林的铋四联疗法治疗感染患者的疗效和安全性。

方法

评估了 2022 年 1 月至 2023 年 6 月在浙江大学医学院附属邵逸夫医院接受四环素、阿莫西林、质子泵抑制剂和铋四联治疗 14 天的感染患者。低剂量四环素组患者每日服用四环素 500mg，分两次服用；标准剂量组患者每日服用四环素 750mg，分两次服用或 500mg，分三次服用。主要终点为根除率和治疗相关不良反应。

结果

218 例患者的平均年龄为 48.7±14.0 岁，120 例（55%）为男性，118 例（54.1%）接受了一线治疗。此外，73 例（33%）患者接受了低剂量四环素（500mg，每日两次），145 例（67%）接受了标准剂量四环素，其中 500mg，每日三次在 74 例（33%）中，750mg，每日两次在 71 例（33%）中。在意向治疗分析中，500mg，每日两次组的根除率为 89%（95%可信区间：82%-96%），500mg，每日三次组为 82%（95%可信区间：74%-91%），750mg，每日两次组为 79%（95%可信区间：69%-89%），差异无统计学意义（ = 0.25）。低剂量组不良反应发生率低于标准剂量组（12.3% vs. 31.1% 或 23.9%； = 0.02）。