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. 2023 Jul 11;18(1):20230722.
doi: 10.1515/med-2023-0722. eCollection 2023.

Efficacy analysis of empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy as a first-line Helicobacter pylori eradication regimen - An open-label, randomized trial

Xin Jiang  1   2 , Bin Deng  1   2 , Xuefeng Gao  1   2 , Yun Zhang  3 , Guangyao Li  1   2 , Guiqing Li  1   2 , Qiang She  2   4 , Yanbing Ding  2   4
Affiliations

Efficacy analysis of empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy as a first-line Helicobacter pylori eradication regimen - An open-label, randomized trial

Xin Jiang et al. Open Med (Wars). .

Abstract

This research aimed to evaluate the eradication efficacy, safety, and gastrointestinal symptom relief rates of empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy in primary eradication patients in Yangzhou, China. It also investigated the possible factors influencing the success of different Helicobacter pylori eradication regimens. A single-center, prospective, open-label, randomized controlled study was performed from December 2020 and October 2021, in which 255 patients with H. pylori infection were assigned in a 1:1:1 ratio to the three different groups. Our results showed that high-dose dual therapy (91.0%, 71/78) and resistance gene-based triple therapy (94.9%, 75/79) achieved eradication rates and compliance equivalent to those of empirical bismuth quadruple therapy (85.3%, 64/75) in the per-protocol analysis, while high-dose dual therapy had lower rates of adverse events (11.5%, 9/78, P < 0.05), fewer side effects, and greater safety. Most patients' gastrointestinal discomfort symptoms improved after eradication of H. pylori. Poor compliance (P < 0.05) and antibiotic resistance (P < 0.05) were risk factors for the efficacy of H. pylori eradication. Therefore, the appropriate regimen can be individualized for eradication therapy in clinical practice according to the patient's resistance and tolerance to the drug.

Keywords: Helicobacter pylori; empirical bismuth quadruple therapy; eradication efficacy; high-dose dual therapy; resistance-based triple therapy.

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Conflict of interest statement

Conflict of interest: All the authors disclose no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart. ITT, intention-to-treat; mITT, modified intention-to-treat; PP, per-protocol.
Figure 2
Figure 2
Procedures for selecting sensitive antibiotic therapy based on H. pylori resistance gene test results. R, rabeprazole; A, amoxicillin; C, clarithromycin; M: metronidazole; L: levofloxacin; F: furazolidone; T, tetracycline.
Figure 3
Figure 3
Comparison of eradication rates between three therapy groups.
Figure 4
Figure 4
Improvement in gastrointestinal symptoms after H. pylori eradication.
See this image and copyright information in PMC

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References

    1. Zamani M, Ebrahimtabar F, Zamani V, Miller WH, Alizadeh-Navaei R, Shokri-Shirvani J, et al. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther. 2018;47:868–76. 10.1111/apt.14561. - DOI - PubMed
    1. Xie C, Lu NH. Review: clinical management of Helicobacter pylori infection in China. Helicobacter. 2015;20:1–10. 10.1111/hel.12178. - DOI - PubMed
    1. Savoldi A, Carrara E, Graham DY, Conti M, Tacconelli E. Prevalence of antibiotic resistance in Helicobacter pylori: a systematic review and meta-analysis in World Health Organization regions. Gastroenterology. 2018;155:1372–82, e1317. 10.1053/j.gastro.2018.07.007. - DOI - PMC - PubMed
    1. Thung I, Aramin H, Vavinskaya V, Gupta S, Park JY, Crowe SE, et al. Review article: the global emergence of Helicobacter pylori antibiotic resistance. Aliment Pharmacol Ther. 2016;43:514–33. 10.1111/apt.13497. - DOI - PMC - PubMed
    1. Graham DY, Fischbach L. Helicobacter pylori treatment in the era of increasing antibiotic resistance. Gut. 2010;59:1143–53. 10.1136/gut.2009.192757. - DOI - PubMed

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