摘要
AIM: To determine the efficacy of our therapeutic strategy for Helicobacter pylori (H. pylori) eradication and to identify predictive factors for successful eradication. METHODS: From April 2006 to June 2010, we retrospectively assessed 2428 consecutive patients (1025 men, 1403 women; mean age 55 years, age range 18-92 years) with gastric histology positive for H. pylori infection referred to our unit for 13-C urea breath test(UBT), after first-line therapy with proton pump inhibitor (PPI) b.i.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 d. Patients who were still positive to UBT were recommended a second-line therapy (PPI b.i.d. + amoxicillin 1 g b.i.d. + tinidazole 500 mg b.i.d. for 14 d). Third choice treatment was empirical with PPI b.i.d. + amoxicillin 1 g b.i.d. + levofloxacin 250 mg b.i.d. for 14 d. RESULTS: Out of 614 patients, still H. pylori-positive after first-line therapy, only 326 and 19 patients respectively rechecked their H. pylori status by UBT after the suggested second and third-line regimens. "Per protocol" eradication rates for first, second and thirdline therapy were 74.7% (95% CI: 72.7%-76.4%), 85.3% (95% CI: 81.1%-89.1%) and 89.5% (95% CI: 74.9%-103%) respectively. The overall percentage of patients with H. pylori eradicated after two treatments was 97.8% (95% CI: 97.1%-98.4%), vs 99.9% (95% CI: 99.8%-100%) after three treatments. The study found that eradication therapy was most effective in patients with ulcer disease (P < 0.05, P = 0.028), especially in those with duodenal ulcer. Smoking habits did not significantly affect the eradication rate. CONCLUSION: First-line therapy with amoxicillin and clarithromycin produces an H. pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.
AIM： To determine the efficacy of our therapeutic strategy for Helicobacter pylori （H. pylori） eradication and to identify predictive factors for successful eradication. METHODS： From April 2006 to June 2010, we retrospectively assessed 2428 consecutive patients （1025 men, 1403 women; mean age 55 years, age range 18-92 years） with gastric histology positive for H. pylori infection referred to our unit for 13-C urea breath test（UBT）, after first-line therapy with proton pump inhibitor （PPI） b.i.d. ＋ amoxicillin 1 g b.i.d. ＋ clarithromycin 500 mg b.i.d. for 7 d. Patients who were still positive to UBT were recommended a second-line therapy （PPI b.i.d. ＋ amoxicillin 1 g b.i.d. ＋ tinidazole 500 mg b.i.d. for 14 d）. Third choice treatment was empirical with PPI b.i.d. ＋ amoxicillin 1 g b.i.d. ＋ levofloxacin 250 mg b.i.d. for 14 d. RESULTS： Out of 614 patients, still H. pylori-positive after first-line therapy, only 326 and 19 patients respectively rechecked their H. pylori status by UBT after the suggested second and third-line regimens. ＂Per protocol＂ eradication rates for first, second and thirdline therapy were 74.7% （95% CI： 72.7%-76.4%）, 85.3% （95% CI： 81.1%-89.1%） and 89.5% （95% CI： 74.9%-103%） respectively. The overall percentage of patients with H. pylori eradicated after two treatments was 97.8% （95% CI： 97.1%-98.4%）, vs 99.9% （95% CI： 99.8%-100%） after three treatments. The study found that eradication therapy was most effective in patients with ulcer disease （P 〈 0.05, P = 0.028）, especially in those with duodenal ulcer. Smoking habits did not significantly affect the eradication rate. CONCLUSION： First-line therapy with amoxicillin and clarithromycin produces an H. pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.
关键词
幽门螺旋杆菌
治疗方案
感染情况
根除
疗效
阿莫西林
质子泵抑制剂
平均年龄
Helicobacter pylori Eradication treatment Rescue therapy Eradication rate Triple therapy Firstline therapy Second-line therapy
