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Comparison of the efficacy of triple versus quadruple therapy on the eradication of Helicobacter pylori and antibiotic resistance
Author(s) -
ZHENG Qing,
CHEN Wan Jun,
LU Hong,
SUN Qin Juan,
XIAO Shu Dong
Publication year - 2010
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/j.1751-2980.2010.00457.x
Subject(s) - medicine , helicobacter pylori , antibiotic resistance , antibiotics , antibiotic therapy , helicobacter infections , microbiology and biotechnology , biology
OBJECTIVE: Our aim was to compare the efficacy and safety of Helicobacter pylori ( H. pylori ) eradication with pantoprazole‐based 7‐day standard triple therapy (PAC) and 10‐day quadruple therapy (PBMT), and to study the primary resistance of H. pylori to amoxicillin, clarithromycin, metronidazole and tetracycline. METHODS: A total of 170 patients with non‐ulcer dyspepsia (NUD) and H. pylori infection were allocated to two study groups. The PAC group received pantoprazole 40 mg b.i.d., amoxicillin 1.0 g b.i.d. and clarithromycin 500 mg b.i.d. for 7 days; the PBMT group received pantoprazole 40 mg b.i.d., colloidal bismuth subcitrate 220 mg b.i.d, metronidazole 400 mg t.i.d. and tetracycline 750 mg b.i.d. for 10 days. A total of 80 H. pylori strains were isolated and antibiotic resistance was measured by the agar dilution method. RESULTS: A total of 166 patients completed the therapy. The intention‐to‐treat eradication rates in the PAC and PBMT groups were 63.5% and 89.4%, respectively ( P < 0.05). By per protocol analysis, the eradication rates of the two groups were 65.1% and 91.6%, respectively ( P < 0.05). Overall 77 clinical isolated H. pylori strains were cultured successfully. The H. pylori primary resistance rates to metronidazole and clarithromycin were 41.6% and 20.8%, respectively, whereas all the H. pylori isolates were sensitive to amoxicillin and tetracycline. CONCLUSION: The efficacy of PAC declines in many regions in China because of high antibiotic resistance rates. The PBMT regimen achieved a high eradication rate of H. pylori and might be used as a first‐line therapy.