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Two Different 1-Week Quadruple Therapies Given Back-to-Back Consecutive Therapy for Difficult-to-Treat Helicobacter pylori Infection: A Pilot Study.
- Source :
-
Clinical and translational gastroenterology [Clin Transl Gastroenterol] 2021 Aug 16; Vol. 12 (8), pp. e00391. Date of Electronic Publication: 2021 Aug 16. - Publication Year :
- 2021
-
Abstract
- Introduction: We aim to evaluate the efficacy of 2 different 1-week quadruple therapies given back-to-back consecutive therapy in patients with difficult-to-treat Helicobacter pylori infection.<br />Methods: Patients with proven H. pylori infection were recruited after >3 failed standard quadruple eradication. They received consecutive therapy consisting of esomeprazole 40 mg or rabeprazole 20 mg twice daily, amoxicillin 1,000 mg twice daily, tetracycline 500 mg 4 times daily, and furazolidone 100 mg 3 times daily for the first 7 days, followed by colloidal bismuth pectin 200 mg twice daily in place of furazolidone 100 mg for another 7 days. Eradication rates, treatment-emergent adverse events (TEAEs), and compliance were assessed.<br />Results: Sixty-five patients were enrolled. The mean number of previous eradications was 3.6 (range: 3-7). The intention-to-treat and per-protocol eradication rates were 90.8% (59/65) and 95.1% (58/61). In total, 23.4% (15/64) of patients experienced drug-related TEAEs. No serious adverse events were observed. None of the patients required treatment for TEAEs, and 95.3% (61/64) showed good compliance. Overall, 51 patients (78.5%) were with the available antimicrobial susceptibility testing results. The resistance rates to clarithromycin, metronidazole, levofloxacin, and amoxicillin were 60.8% (31/51), 100% (51/51), 70.6% (36/51), and 2.0% (1/51), respectively. No resistance was detected to either furazolidone or tetracycline. However, in 54.9% of patients (28/51), H. pylori was resistant to 3 antibiotics (metronidazole, levofloxacin, and clarithromycin).<br />Discussion: Consecutive therapy, including amoxicillin, tetracycline, and furazolidone, achieved a good eradication rate (>90%), with desirable compliance and tolerability in difficult-to-treat H. pylori infection.<br /> (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
- Subjects :
- Amoxicillin administration & dosage
Amoxicillin adverse effects
Antacids administration & dosage
Anti-Bacterial Agents adverse effects
Bismuth administration & dosage
Drug Administration Schedule
Drug Resistance, Bacterial
Drug Therapy, Combination
Female
Furazolidone administration & dosage
Furazolidone adverse effects
Helicobacter Infections microbiology
Humans
Male
Medication Adherence
Middle Aged
Pilot Projects
Proton Pump Inhibitors administration & dosage
Tetracycline administration & dosage
Tetracycline adverse effects
Treatment Outcome
Anti-Bacterial Agents administration & dosage
Helicobacter Infections drug therapy
Helicobacter pylori
Subjects
Details
- Language :
- English
- ISSN :
- 2155-384X
- Volume :
- 12
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Clinical and translational gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 34397042
- Full Text :
- https://doi.org/10.14309/ctg.0000000000000391