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学科主题: 临床医学
题名:
A Comparative Study of Sequential Therapy and Standard Triple Therapy for Helicobacter pylori Infection: A Randomized Multicenter Trial
作者: Zhou, Liya1; Zhang, Jianzhong2; Chen, Minhu3; Hou, Xiaohua4; Li, Zhaoshen5; Song, Zhiqiang1; He, Lihua2; Lin, Sanren1
刊名: AMERICAN JOURNAL OF GASTROENTEROLOGY
发表日期: 2014-04-01
DOI: 10.1038/ajg.2014.26
卷: 109, 期:4, 页:535-541
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Gastroenterology & Hepatology
研究领域[WOS]: Gastroenterology & Hepatology
关键词[WOS]: CONCOMITANT THERAPY ; ANTIBIOTIC-RESISTANCE ; CONSENSUS REPORT ; OPEN-LABEL ; ERADICATION ; MANAGEMENT ; LEVOFLOXACIN ; METAANALYSIS ; CHILDREN ; EFFICACY
英文摘要:

OBJECTIVES: Studies conducted in large populations of patients and providing full information on Helicobacter pylori (H. pylori) antibiotic resistance are needed to determine the efficacy of sequential therapy (SQT) against this pathogen. This study compared eradication rates with SQT and standard triple therapy (STT), and evaluated the impact of antibiotic resistance on outcomes.

METHODS: The study population included adults with positive H. pylori culture presenting at four centers in China between March 2008 and December 2010. Patients were randomly assigned to 10 days of treatment with esomeprazole, amoxicillin, and clarithromycin (STT; n=140) or to 5 days of treatment with esomeprazole and amoxicillin, followed by 5 days of esomeprazole, clarithromycin, and tinidazole (SQT; n=140). Eradication was assessed 8 -12 weeks after treatment.

RESULTS: There was no significant difference between the eradication rates achieved with STT (66.4 % (95 % confidence interval (CI) 59.3-74.3)) and SQT (72.1% (65.0-79.3); P=0.300) in either the intention-to-treat analysis or the per-protocol analysis (72.7 % (65.6-79.7) and 76.5 % (69.7-83.3), respectively; P = 0.475). Clarithromycin resistance (CLA-R, odds ratio (OR) = 8.34 (3.13-22.26), P < 0.001) and metronidazole resistance (MET-R, OR = 7.14 (1.52-33.53), P = 0.013) both independently predicted treatment failure in the SQT group. Patients in the SQT group with dual CLA-R and MET-R had a lower eradication rate (43.9 %) than those with isolated CLA-R (88.9 %, P=0.024) or isolated MET-R (87.8 %, P<0.001).

CONCLUSIONS: H. pylori eradication rates with STT and SQT were compromised by antibiotic resistance. SQT may be suitable in regions with high prevalence of isolated CLA-R, but it is unsatisfactory when both CLA-R and MET-R are present.

语种: 英语
所属项目编号: 2007BAI04B02
项目资助者: National Science &amp ; Technology Pillar Program of 11th Five-Year Plan in China
WOS记录号: WOS:000335450300010
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/59588
Appears in Collections:北京大学第三临床医学院_消化科_期刊论文

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作者单位: 1.Peking Univ, Hosp 3, Dept Gastroenterol, Beijing 100191, Peoples R China
2.Chinese Ctr Dis Control & Prevent, Natl Inst Communicable Dis Control & Prevent, State Key Lab Infect Dis Prevent & Control, Collaborat Innovat Ctr Diag & Treatment Infect Di, Beijing, Peoples R China
3.Sun Yat Sen Univ, Affiliated Hosp 1, Dept Gastroenterol, Guangzhou 510275, Guangdong, Peoples R China
4.Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Div Gastroenterol, Wuhan 430074, Peoples R China
5.Second Mil Med Univ, Changhai Hosp, Dept Digest Dis, Shanghai, Peoples R China

Recommended Citation:
Zhou, Liya,Zhang, Jianzhong,Chen, Minhu,et al. A Comparative Study of Sequential Therapy and Standard Triple Therapy for Helicobacter pylori Infection: A Randomized Multicenter Trial[J]. AMERICAN JOURNAL OF GASTROENTEROLOGY,2014,109(4):535-541.
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