Tailored Helicobacter pylori eradication based on prior intake of macrolide antibiotics allows the use of triple therapy with optimal results in an area with high clarithromycin resistance
| Autor: | Pablo Munoz Gomez, Cristian Sierra Bernal, César Gómez Hernando, Eva de Andrés, Rafael Gómez Rodríguez, Julio Valle Muñoz |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.drug_class macromolecular substances Drug resistance Microbial Sensitivity Tests Quinolones Group B Macrolide Antibiotics Helicobacter Infections 03 medical and health sciences Young Adult 0302 clinical medicine Pharmacotherapy Internal medicine Clarithromycin Metronidazole Drug Resistance Bacterial medicine Electronic Health Records Humans Prospective Studies Young adult Prospective cohort study Aged Aged 80 and over Intention-to-treat analysis biology Helicobacter pylori business.industry Gastroenterology Amoxicillin Proton Pump Inhibitors General Medicine Middle Aged Tetracycline biology.organism_classification Anti-Bacterial Agents Intention to Treat Analysis 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Drug Therapy Combination Female Macrolides business Bismuth Omeprazole |
| Zdroj: | Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva. 111(9) |
| ISSN: | 1130-0108 |
| Popis: | Background: the previous intake of macrolide antibiotics is associated with a failure to eradicate Helicobacter pylori (H. pylori) with clarithromycin-containing regimens. However, the standard triple therapy achieves eradication rates of over 90% in patients without a previous use of macrolides in our health area. The aim of this study was to evaluate the efficacy of an H. pylori eradication strategy based on the intake of macrolides by the patient during the previous years. Methods: one hundred and sixty-nine patients with H. pylori infection were prospectively included in the study. The electronic medical record of each patient was reviewed at the time of inclusion. Depending on their previous intake of macrolides, patients were assigned to one of two eradication regimens: group A) patients without a previous intake of macrolides received an optimized triple therapy for 14 days; and group B) patients with a previous intake of macrolides received bismuth quadruple therapy for ten days. Results: ninety-one patients (53.84%) without a previous intake of macrolides received an optimized triple therapy (group A) and 78 patients (46.15%) with a previous intake of macrolides received bismuth quadruple therapy (group B). In group A, the H. pylori eradication rates were 90.11% in the intention-to-treat and 95.35% in the per-protocol analysis. In group B, the H. pylori eradication rates were 85.89% in the intention-to-treat and 98.5% in the per-protocol analysis. The overall eradication rates obtained using this strategy were 88.16% (95% CI: 82.32-92.02%) in the intention-to-treat and 96.75% (95% CI: 92.59-98.94%) in the per-protocol analysis. Conclusions: an H. pylori eradication strategy based on the intake of macrolides during the previous years achieves overall eradication rates close to 90% and allows the use of standard triple therapy in more than half of the patients from a health area with a high level of clarithromycin resistance. |
| Databáze: | OpenAIRE |
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