Efficacy and safety of a 14-day modified concomitant therapy for refractory Helicobacter pylori infection : a pilot study

© 2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd..

BACKGROUND AND AIM: After three treatment failures, Helicobacter pylori infection is deemed refractory as antibiotic treatment options become significantly limited. This study evaluated the efficacy and safety of a 14-day modified concomitant therapy for managing refractory H. pylori infection.

METHODS: Patients who had failed to respond to three or more rounds of H. pylori therapies were recruited for this study. They received a 14-day modified concomitant therapy, including esomeprazole 40 mg, amoxicillin 1000 mg, and furazolidone 100 mg twice daily and tetracycline 500 mg four times daily. Demographic data, adverse events, and patient compliance were recorded. The presence of H. pylori was reevaluated 6 weeks following treatment. Eradication rate was assessed as the primary outcome.

RESULTS: Overall, 59 participants received the 14-day modified concomitant therapy. In the intention-to-treat and per-protocol analyses, the eradication rate was 84.7% (50/59) and 89.3% (50/56), respectively. H. pylori was successfully isolated from 75.0% (12/16) of patients. The resistance rate of H. pylori to metronidazole, levofloxacin, and clarithromycin was 91.7% (11/12), 58.3% (7/12), and 50.0% (6/12), respectively. Resistance to amoxicillin, furazolidone, or tetracycline was not observed. The frequency of adverse events was 35.6% (21/59), with no serious adverse events reported.

CONCLUSION: The 14-day modified concomitant therapy appears to be appropriate for refractory H. pylori infection and is particularly promising for the Chinese population. A randomized controlled trial is warranted to verify its efficacy, especially in the current environment of increasing antibiotic resistance.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:38

Enthalten in:

Journal of gastroenterology and hepatology - 38(2023), 12 vom: 31. Dez., Seite 2097-2103

Sprache:

Englisch

Beteiligte Personen:

Zeng, Shu-Yan [VerfasserIn]
Wang, Juan [VerfasserIn]
Liu, Jing [VerfasserIn]
Lin, Min-Juan [VerfasserIn]
Lin, Bo-Shen [VerfasserIn]
Ding, Yu-Ming [VerfasserIn]
Kong, Qing-Zhou [VerfasserIn]
Zhang, Wen-Lin [VerfasserIn]
Duan, Miao [VerfasserIn]
Han, Zhong-Xue [VerfasserIn]
Li, Yue-Yue [VerfasserIn]
Zuo, Xiu-Li [VerfasserIn]
Li, Yan-Qing [VerfasserIn]

Links:

Volltext

Themen:

140QMO216E
5J9CPU3RE0
804826J2HU
Amoxicillin
Anti-Bacterial Agents
Clarithromycin
Furazolidone
H1250JIK0A
Helicobacter pylori
Journal Article
Metronidazole
Pilot study
Rescue treatment
Tetracycline

Anmerkungen:

Date Completed 25.12.2023

Date Revised 25.12.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/jgh.16348

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM361994354