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Efficacy and safety of a 14-day modified concomitant therapy for refractory Helicobacter pylori infection: a pilot study.
Zeng, Shu-Yan; Wang, Juan; Liu, Jing; Lin, Min-Juan; Lin, Bo-Shen; Ding, Yu-Ming; Kong, Qing-Zhou; Zhang, Wen-Lin; Duan, Miao; Han, Zhong-Xue; Li, Yue-Yue; Zuo, Xiu-Li; Li, Yan-Qing.
Affiliation
  • Zeng SY; Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Wang J; Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Liu J; Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Lin MJ; Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Lin BS; Hospital Development Center of Qingdao Municipal Health Commission, Qingdao, Shandong, China.
  • Ding YM; Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Kong QZ; Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Zhang WL; Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Duan M; Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Han ZX; Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Li YY; Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Zuo XL; Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
  • Li YQ; Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
J Gastroenterol Hepatol ; 38(12): 2097-2103, 2023 Dec.
Article in En | MEDLINE | ID: mdl-37702104
ABSTRACT
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.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Helicobacter pylori / Helicobacter Infections Type of study: Clinical_trials / Guideline Limits: Humans Language: En Journal: J Gastroenterol Hepatol Journal subject: GASTROENTEROLOGIA Year: 2023 Document type: Article Affiliation country:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Helicobacter pylori / Helicobacter Infections Type of study: Clinical_trials / Guideline Limits: Humans Language: En Journal: J Gastroenterol Hepatol Journal subject: GASTROENTEROLOGIA Year: 2023 Document type: Article Affiliation country: