Comparison of sequential therapy and amoxicillin/tetracycline containing bismuth quadruple therapy for the first-line eradication of Helicobacter pylori: a prospective, multi-center, randomized clinical trial.
Background: The <80 % Helicobacter pylori eradication rate with sequential therapy is unsatisfactory. Modified bismuth quadruple therapy, replacing metronidazole with amoxicillin, could be promising because H. pylori resistance to tetracycline or to amoxicillin is relatively low. A 14-day modified b...
| Publicado en: | BMC Gastroenterology Vol. 16; pp. 1 - 9 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
BioMed Central
7/26/2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=117060409&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 117060409 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1471230X 1CHO jtl: BMC Gastroenterology issn: 1471230X maglogo: N pubinfo: dt: 7/26/2016 vid: 16 pid: 24147 pub: BioMed Central artinfo: ui: 117060409 117060409 NLM27460100 117060409 10.1186/s12876-016-0490-8 NLM27460100 PMC4962407 117060409 ppf: 1 ppct: 8 formats: tig: atl: Comparison of sequential therapy and amoxicillin/tetracycline containing bismuth quadruple therapy for the first-line eradication of Helicobacter pylori: a prospective, multi-center, randomized clinical trial. aug: au: Ju Yup Lee Nayoung Kim Kyung Sik Park Hyun Jin Kim Seon Mee Park Gwang Ho Baik Ki-Nam Shim Jung Hwan Oh Suck Chei Choi Sung Eun Kim Won Hee Kim Seon-Young Park Gwang Ha Kim Bong Eun Lee Yunju Jo Su Jin Hong Lee, Ju Yup Kim, Nayoung Park, Kyung Sik Kim, Hyun Jin affil: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea sug: subj: Antacids Therapeutic Use Antibiotics Therapeutic Use Helicobacter Pylori Drug Effects Bismuth Therapeutic Use Tetracycline Therapeutic Use Gastritis Drug Therapy Amoxicillin Therapeutic Use Helicobacter Infections Drug Therapy Male Treatment Failure Medication Compliance Tetracycline Adverse Effects Antibiotics Adverse Effects Human Antacids Adverse Effects Gastritis Microbiology Female Drug Administration Schedule Bismuth Adverse Effects Drug Therapy, Combination Helicobacter Infections Microbiology Amoxicillin Adverse Effects Drug Resistance, Microbial Middle Age Prospective Studies Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Scales Middle Aged: 45-64 years Male Female ab: Background: The <80 % Helicobacter pylori eradication rate with sequential therapy is unsatisfactory. Modified bismuth quadruple therapy, replacing metronidazole with amoxicillin, could be promising because H. pylori resistance to tetracycline or to amoxicillin is relatively low. A 14-day modified bismuth quadruple protocol as first-line H. pylori treatment was compared with 10-day sequential therapy. Methods: In total, 390 H. pylori-infected subjects participated in the randomized clinical trial: 10-day sequential therapy (40 mg pantoprazole plus 1 g amoxicillin twice a day for 5 days, then 40 mg pantoprazole and 500 mg clarithromycin twice a day and 500 mg metronidazole three times a day for 5 days) or 14-day modified bismuth quadruple therapy (40 mg pantoprazole, 600 mg bismuth subcitrate, 1 g tetracycline, and 1 g amoxicillin, twice a day). (13)C-urea breath test, rapid urease testing, or histology was performed to check for eradication. Results: Intention-to-treat (ITT) eradication rates of 10-day sequential and 14-day quadruple therapy were 74.6 % and 68.7 %, respectively, and the per-protocol (PP) rates were 84.2 and 76.5 %, respectively. The eradication rate was higher in the sequential therapy group, but neither the ITT nor the PP analyses had a significant difference (P = 0.240 and P = 0.099, respectively). However, the adverse events were significantly lower in the modified bismuth quadruple therapy group than the sequential therapy group (36.9 vs. 47.7 %, P = 0.040). Conclusions: Ten-day sequential therapy appears to be more effective despite frequent adverse events. However, both 10-day SQT and 14-day PBAT did not reach the excellent eradication rates that exceed 90 %. Additional trials are needed to identify a more satisfactory first-line eradication therapy. Trial Registration: ClinicalTrials.gov ( NCT02159976 ); Registration date: 2014-06-03, CRIS ( KCT0001176 ); Registration date: 2014-07-23. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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