Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan 10:11:1510376.
doi: 10.3389/fmed.2024.1510376. eCollection 2024.

Effect of an individualized bismuth quadruple regimen guided by 10-day or 14-day antibiotic susceptibility testing for first-line eradication treatment of Helicobacter pylori in Ningxia, China

Xiaoming Su  1 , Yanhong Deng  2 , Xianmei Chen  2 , Yanling Li  2 , Qian Hao  2 , Yuanyuan Tang  2 , Rui Mu  2 , Yuting Wu  2 , Yan Zhou  3 , Shengjuan Hu  2
Affiliations

Effect of an individualized bismuth quadruple regimen guided by 10-day or 14-day antibiotic susceptibility testing for first-line eradication treatment of Helicobacter pylori in Ningxia, China

Xiaoming Su et al. Front Med (Lausanne). .

Abstract

Introduction: Helicobacter pylori (H. pylori) is becoming more resistant to antibiotics, and the implementation of individualized therapy is highly valuable for its eradication. This study aimed to investigate the efficacy and safety of individualized treatment guided by antibiotic susceptibility testing (AST) with a 10-day or 14-day course for the eradication of H. pylori.

Methods: This was a prospective, open-label, single-center, quasi-randomized trial in which 220 participants were randomized into groups based on AST results as AST-10-day (n = 98) and AST-14-day (n = 112) treatment groups. All participants were retested for a 14-carbon urease breath test at weeks 4-8 after the end of the treatment.

Results: The primary resistance rates of H. pylori to metronidazole, levofloxacin, clarithromycin, and amoxicillin were 94.1% (207/220), 42.7% (95/220), 41.4% (91/220), and 0.9% (2/220), respectively; however, no resistance to furazolidone and tetracycline was observed. In the AST-10-day and AST-14-day groups, the intention-to-treat (ITT) eradication rates were 89.8% (88/98) and 90.2% (110/122), respectively, with no statistically significant difference (p = 0.928). The per-protocol (PP) eradication rates were 92.6% (88/95) and 98.2% (110/112), respectively, with a statistically significant difference (p = 0.049). The incidence rates of adverse events (AEs) in the AST-10-day and AST-14-day groups were 6.3% (6/95) and 7.2% (8/112), respectively, with no statistically significant difference (p = 0.813). No statistically significant difference was observed in compliance between the two groups (p = 0.467).

Conclusion: Both 10-day and 14-day AST guided individualized therapy can achieve satisfactory eradication effect. Compared with the 14-day regimen, the 10-day regimen has similar eradication rate and incidence of adverse events and compliance but shorter duration and lower cost.

Keywords: Helicobacter pylori; adverse events; antibiotic sensitivity test; eradication rate; individualized therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of this study. AST, antibiotic susceptibility testing; ITT, intention-to-treat; PP, per-protocol.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Sugano K, Tack J, Kuipers EJ, Graham DY, El-Omar EM, Miura S, et al. . Kyoto global consensus report on Helicobacter pylori gastritis. Gut. (2015) 64:1353–67. doi: 10.1136/gutjnl-2015-309252, PMID: - DOI - PMC - PubMed
    1. Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. . Management of Helicobacter pylori infection-the Maastricht V/Florence consensus report. Gut. (2017) 66:6–30. doi: 10.1136/gutjnl-2016-312288, PMID: - DOI - PubMed
    1. Liu WZ, Xie Y, Lu H, Cheng H, Zeng ZR, Zhou LY, et al. . Fifth Chinese National Consensus Report on the management of Helicobacter pylori infection. Helicobacter. (2018) 23:e12475. doi: 10.1111/hel.12475, PMID: - DOI - PubMed
    1. Hu Y, Zhang M, Lu B, Dai J. Helicobacter pylori and antibiotic resistance, a continuing and intractable problem. Helicobacter. (2016) 21:349–63. doi: 10.1111/hel.12299, PMID: - DOI - PubMed
    1. Yu Y, Xue J, Lin F, Liu D, Zhang W, Ru S, et al. . Global primary antibiotic resistance rate of helicobacter pylori in recent 10 years: a systematic review and meta-analysis. Helicobacter. (2024) 29:e13103. doi: 10.1111/hel.13103, PMID: - DOI - PubMed

LinkOut - more resources