Tailored susceptibility-guided therapy via gastric juice PCR for the first-line H. pylori eradication, a randomized controlled trial
| Autor: | Neng-Sheng Chu, Pei-Yun Tsai, I-Chen Wu, Meng-Shu Hsieh, Fang-Jung Yu, Jiunn-Wei Wang, Chao-Hung Kuo, Chung-Jung Liu, Fu-Chen Kuo, Jeng-Yih Wu, Meng-Chieh Wu, Ping-I. Hsu, Deng-Chyang Wu |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
First line Polymerase Chain Reaction Gastroenterology Helicobacter Infections law.invention First line therapy Antibiotic resistance Randomized controlled trial law Levofloxacin Clarithromycin Internal medicine Clarithromycin resistance medicine Humans Prospective Studies Gastric Juice Helicobacter pylori business.industry Amoxicillin Proton Pump Inhibitors General Medicine Anti-Bacterial Agents Drug Therapy Combination business medicine.drug |
| Zdroj: | Journal of the Formosan Medical Association. 121:1450-1457 |
| ISSN: | 0929-6646 |
| DOI: | 10.1016/j.jfma.2021.10.011 |
| Popis: | BACKGROUND/PURPOSE Clarithromycin-based standard triple therapy is still commonly adopted by 81.4% of physicians in real-world practice but yields low eradication rates. Therefore, we conducted this study to compare the efficacy of gastric juice-guided therapy for first-line eradication with the standard triple therapy, in order to provide an alternative to real-world practice. METHODS A total of 182 treatment-naive Hp-infected patients were included and randomly allocated to either susceptibility-guided therapy (SGT) with gastric juice PCR or Clarithromycin-based standard triple therapy (STT) for 7 days. RESULTS The intention-to-treat eradication rates were 89% (81/91) in SGT and 75.8% in STT (p < 0.031). The per-protocol eradication rates were 91.0% (81/89) in SGT and 79.3% (69/87) in STT (p < 0.034). Among the subgroups of different antibiotic resistance, patients with SGT demonstrated superior eradication rates (91.7% vs 45.5%, p < 0.027) in the subgroup of both clarithromycin resistance and levofloxacin resistance. CONCLUSION This prospective randomized controlled trial demonstrated the reliable efficacy of susceptibility-guided therapy via gastric juice PCR for the first-line Hp eradication. In Asia-Pacific area, where standard triple therapy is still adopted by the majority of the physicians, it is a recommended alternative to overcome the increasing antibiotic resistance. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|