Risk factors of rescue bismuth quadruple therapy failure for Helicobacter pylori eradication.
J Gastroenterol Hepatol
; 34(4): 666-672, 2019 Apr.
Article
en En
| MEDLINE
| ID: mdl-30726563
ABSTRACT
BACKGROUND AND AIM:
Failure of bismuth quadruple therapy for Helicobacter pylori eradication is frequently observed. To increase the eradication rate, comprehensive analyses need to be performed regarding risk factors of bismuth quadruple therapy failure based on complete standard culture and antimicrobial susceptibility testing results.METHODS:
Patients with history of failed first therapy who had H. pylori colonies isolated from culture and successful minimum inhibitory concentration (MIC) test were enrolled. Esomeprazole, bismuth, metronidazole, and tetracycline (quadruple) therapies for 7 or 14 days were given. Eradication rate, treatment compliance, adverse events, and risk factors for the failure of bismuth quadruple therapy were analyzed.RESULTS:
A total 54 patients were enrolled. Overall eradication rate in the present study was 88.8%. The eradication rate for cases with metronidazole resistance such as MIC 8-16 µg/mL or 16-32 µg/mL was 92.8% (13/14). For cases with high level metronidazole resistance (MIC > 32 µg/mL), the eradication rate was only 60% (6/10). Multivariate analysis regarding compliance, treatment duration, age > 60, three kinds of metronidazole MICs, tetracycline MIC > 4 µg/mL, adverse events and any other parameters, "metronidazole resistance, high level (MIC > 32 µg/mL)" was the only independent risk factor for eradication failure (P = 0.007).CONCLUSION:
For cases with metronidazole resistance at MIC > 32 µg/mL, rescue therapy other than bismuth-containing quadruple therapy is needed.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Bismuto
/
Helicobacter pylori
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Infecciones por Helicobacter
/
Insuficiencia del Tratamiento
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Gastritis
/
Antibacterianos
Tipo de estudio:
Etiology_studies
/
Risk_factors_studies
Límite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2019
Tipo del documento:
Article