Efficacy of Hybrid Therapy and Bismuth Quadruple Therapy in Treatment of Helicobacter pylori Infection
10.3969/j.issn.1008-7125.2017.03.009
- VernacularTitle:混合疗法与含铋剂四联疗法根除幽门螺杆菌感染的疗效观察
- Author:
Xiaojian HE
;
Wen WANG
;
Zhijian ZHANG
;
Kerong LIN
;
Dazhou LI
;
Rong WANG
;
Jianqiang LIU
;
Zhiping CHEN
;
Haitao LI
- Keywords:
Helicobacter pylori;
Hybrid Therapy;
Bismuth Quadruple Therapy;
Eradication;
Safety
- From:Chinese Journal of Gastroenterology
2017;22(3):168-171
- CountryChina
- Language:Chinese
-
Abstract:
Bismuth quadruple therapy is recommended as a first-line therapeutic regimen for Helicobacter pylori (Hp) infection in China.However, the renal toxicity induced by bismuth resulted in limitation of its clinical use.Aims: To assess the efficacy and safety of hybrid therapy for initial eradication of Hp infection.Methods: One hundred and fifty-two patients proved to be positive for Hp infection and treatment-na(i)ve at the Fuzhou General Hospital of Nanjing Military Command of Chinese PLA from Jan.2014 to Dec.2015 were enrolled and randomized to receive either hybrid therapy (esomeprazole and amoxicillin for 7 days, followed by esomeprazole, amoxicillin, clarithromycin and metronidazole for 7 days) or bismuth quadruple therapy (esomeprazole, amoxicillin, clarithromycin and colloidal bismuth pectin for 14 days).Hp eradication was assessed by 14C/13C-urea breath test at a minimum of 4 weeks after the end of treatment.Results: No significant differences were found in general status between the two groups at baseline (P>0.05).A total of 149 patients completed the therapy.In hybrid therapy group the eradication rate was 97.4% (75/77) by ITT analysis and 98.7% (75/76) by PP analysis;while in bismuth quadruple therapy group the eradication rates by ITT and PP analyses were 89.3% (67/75) and 91.8% (67/73), respectively.Hybrid therapy was superior to bismuth quadruple therapy (P all <0.05).Although the incidence of adverse events was higher in hybrid therapy group than in bismuth quadruple therapy group (29.9% vs.16.0%, P<0.05), none of the patients discontinued the therapy because of severe adverse events.Conclusions: Hybrid therapy showed better efficacy than bismuth quadruple therapy for treatment of Hp infection, and the adverse events were well tolerated.Hybrid therapy might be used as first-line treatment for Hp infection.
