Efficacy of bismuth containing quadruple therapies on Helicobacter pylori eradication in patients with history of antibiotic treatment.
10.11817/j.issn.1672-7347.2018.07.012
- Author:
Dan TANG
1
;
Lingzhi YUAN
1
;
Chun YUE
1
;
Ting CAI
1
;
Yao YAO
1
;
Fen WANG
1
Author Information
1. Department of Gastroenterology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
- Publication Type:Journal Article
- MeSH:
Amoxicillin;
therapeutic use;
Anti-Bacterial Agents;
therapeutic use;
Bismuth;
therapeutic use;
Clarithromycin;
therapeutic use;
Drug Therapy, Combination;
methods;
Furazolidone;
therapeutic use;
Helicobacter Infections;
drug therapy;
Helicobacter pylori;
Humans;
Metronidazole;
therapeutic use;
Proton Pump Inhibitors;
therapeutic use;
Tinidazole;
therapeutic use;
Treatment Outcome
- From:
Journal of Central South University(Medical Sciences)
2018;43(7):772-778
- CountryChina
- Language:Chinese
-
Abstract:
To investigate the efficacy of bismuth containing quadruple therapies on Helicobacter pylori (Hp) eradication in patients with history of antibiotic treatment.
Methods: Hp infected patients (n=327) were allocated into 3 groups. Group A (n=52), patients had no antibiotic history and they took medicine of proton pump inhibitors (PPI) and livzon triple (clarithromycin, tinidazole, and bismuth); group B (n=80), patients had the antibiotic history except for amoxicillin and clarithromycin, and they were treated with PPI, amoxicillin, clarithromycin, and bismuth; group C (n=195), patients suffered failures of Hp therapy or with history of antibiotic abuse, and they were treated with PPI, doxycycline, furazolidone, and bismuth.
Results: Both the intention-to-treat (ITT) analysis (group A 63.5%, group B 76.2%, group C 82.6%, P<0.05) and the pre-protocol (PP) analysis (group A 76.7%, group B 92.4%, group C 96.4%, P<0.05) showed significant difference among the 3 groups, revealing higher elimination in group B and C. The side-effects (20.2%) were mild and tolerable (group A, 28.0%; group B, 10.7%; group C, 22.0%).
Conclusion: Proton pump inhibitors together with the livzon triple regimen have a low rate of Hp eradication and a higher incidence of adverse reactions. The quadruple therapy containing clarithromycin and metronidazole drugs can achieve the satisfactory outcomes based on patient's antibiotic history. For patients with multiple antibiotics, the quadruple therapy containing furazolidone and doxycycline may achieve the satisfactory outcomes, but the adverse resction would be relatively higher.
