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Tailored therapy guided by genotypic resistance of clarithromycin and levofloxacin detected by polymerase chain reaction in the first-line treatment of Helicobacter pylori infection.
Li, Cai Ling; Zhou, Kai; Zhang, Yue Xi; Suo, Bao Jun; Tian, Xue Li; Zhang, Yu Xin; Ren, Xin Lu; Shi, Yan Yan; Zhou, Li Ya; Song, Zhi Qiang.
Afiliación
  • Li CL; Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
  • Zhou K; Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
  • Zhang YX; Department of Gastroenterology, Beijing No. 6 Hospital, Beijing, China.
  • Suo BJ; Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
  • Tian XL; Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
  • Zhang YX; Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
  • Ren XL; Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
  • Shi YY; Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
  • Zhou LY; Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
  • Song ZQ; Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
J Dig Dis ; 25(1): 36-43, 2024 Jan.
Article en En | MEDLINE | ID: mdl-38323705
ABSTRACT

OBJECTIVES:

We aimed to explore the efficacy and safety of tailored therapy guided by genotypic resistance in the first-line treatment of Helicobacter pylori (H. pylori) infection in treatment-naive patients.

METHODS:

Gastric mucosal specimens were taken during gastroscopy, and main mutations of clarithromycin- and levofloxacin-resistant genes were detected by polymerase chain reaction (PCR). Sensitive antibiotics were selected individually for treating H. pylori infection with tailored bismuth-containing quadruple therapy (BQT) consisting of esomeprazole 20 mg twice daily, bismuth potassium citrate 220 mg twice daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily, or levofloxacin 500 mg once daily, or metronidazole 400 mg four times daily. Safety and patient compliance were assessed 1-3 days after eradication. Treatment outcome was evaluated by urea breath test 4-8 weeks after eradication.

RESULTS:

One hundred and thirty-two treatment-naive patients with H. pylori infection were included. PCR results suggested resistance rates of 47.7% and 34.9% for clarithromycin and levofloxacin, respectively, and a dual resistance rate of 18.2%. Eradication rates of tailored BQT were 87.1% and 95.8% by intention-to-treat (ITT) analysis and per-protocol (PP) analysis, respectively. There was no statistically significant difference in the efficacy of 7-day clarithromycin-containing, 7-day levofloxacin-containing, and 14-day full-dose metronidazole-containing BQT (ITT

analysis:

P = 0.488; PP

analysis:

P = 0.833). The incidence of adverse events was 19.7%, and patient compliance was 97.7%.

CONCLUSION:

Tailored BQT guided by genotypic resistance can achieve satisfactory efficacy, safety, and patient compliance in the first-line treatment of H. pylori infection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Helicobacter pylori / Infecciones por Helicobacter Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: J Dig Dis Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Helicobacter pylori / Infecciones por Helicobacter Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: J Dig Dis Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Australia