Retrospective Analysis Confirms Tetracycline Quadruple as Best Helicobacter pylori Regimen in the USA.
Dig Dis Sci
; 64(10): 2893-2898, 2019 10.
Article
em En
| MEDLINE
| ID: mdl-31187323
ABSTRACT
BACKGROUND:
Declining Helicobacter pylori (H. pylori) eradication rates have prompted a switch in first-line therapy from standard triple (PPI, clarithromycin, and amoxicillin) to bismuth-based quadruple therapy. A caveat of the ACG 2017 H. pylori treatment guidelines was a paucity of recent US eradication data.AIM:
To determine Rhode Island H. pylori eradication data, in the largest US study from the last two decades.METHODS:
Electronic records were queried for patients with H. pylori infection diagnosed by pathology, urea breath test, or stool antigen from 2015 to 2017. Demographics, diagnostic test, treatment regimen, and test of cure were extracted. Eradication rates were calculated, and treatment regimens were compared.RESULTS:
A total of 1710 patients were identified (64% female) 825 (46%) diagnosed by breath test, 755 (42%) by biopsy, and 191 (12%) by stool antigen. Full data were obtained on 1101 patients. Seven regimens were used quadruple (64%), triple (25%), doxycycline quadruple (5%), and miscellaneous (6%). Quadruple was superior to triple (85% vs. 75%, P = 0.002), quadruple 14 days versus triple 14 days (87% vs. 79%, P = 0.0052), quadruple 10 days versus triple 10 days (77% vs. 67%, P = 0.33). Increased therapy length improved eradication (quadruple 14 days vs. 10 days, 87% vs. 77%, P = 0.002; triple 14 days versus 10 days 79% vs. 67%, P = 0.13). Finally, substituting doxycycline for tetracycline yielded lower eradication (85% vs. 67%, P = 0.006).CONCLUSION:
Quadruple therapy is superior to triple therapy within the Rhode Island population. Fourteen-day therapy achieves superior eradication compared to 10-day therapy, and doxycycline is inferior to tetracycline for quadruple therapy. Our findings support adherence to ACG and international guidelines advising 14-day quadruple therapy.Palavras-chave
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Bases de dados:
MEDLINE
Assunto principal:
Tetraciclina
/
Bismuto
/
Helicobacter pylori
/
Infecções por Helicobacter
/
Inibidores da Bomba de Prótons
/
Metronidazol
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Dig Dis Sci
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Estados Unidos