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A Comparative Study of Sequential Therapy and Standard Triple Therapy for Helicobacter pylori Infection: A Randomized Multicenter Trial
Zhou, Liya1; Zhang, Jianzhong2; Chen, Minhu3; Hou, Xiaohua4; Li, Zhaoshen5; Song, Zhiqiang1; He, Lihua2; Lin, Sanren1
刊名AMERICAN JOURNAL OF GASTROENTEROLOGY
2014-04-01
DOI10.1038/ajg.2014.26
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
WOS记录号WOS:000335450300010
项目编号2007BAI04B02
资助机构National Science &amp ; Technology Pillar Program of 11th Five-Year Plan in China
引用统计
被引频次:49[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/59588
专题北京大学第三临床医学院_肾内科
北京大学第三临床医学院_消化科
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
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GB/T 7714
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.
APA Zhou, Liya.,Zhang, Jianzhong.,Chen, Minhu.,Hou, Xiaohua.,Li, Zhaoshen.,...&Lin, Sanren.(2014).A Comparative Study of Sequential Therapy and Standard Triple Therapy for Helicobacter pylori Infection: A Randomized Multicenter Trial.AMERICAN JOURNAL OF GASTROENTEROLOGY,109(4),535-541.
MLA Zhou, Liya,et al."A Comparative Study of Sequential Therapy and Standard Triple Therapy for Helicobacter pylori Infection: A Randomized Multicenter Trial".AMERICAN JOURNAL OF GASTROENTEROLOGY 109.4(2014):535-541.
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