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- Title
The Efficacy of Modified Bismuth Quadruple Therapy for Helicobacter pylori Infection in Korea: A Single Arm Prospective Observational Study.
- Authors
Jung Wan Choe; Sung Woo Jung; Seung Young Kim; Jong Jin Hyun; Young Kul Jung; Ja Seol Koo; Hyung Joon Yim; Sang Woo Lee
- Abstract
Background/Aims Recently, we reported that modified bismuth quadruple therapy in which tetracycline was replaced by amoxicillin (PAM-B therapy) showed excellent clinical results in Korea. Further prospective longitudinal analysis with larger number was performed in our hospital. The aim of this study was to evaluate the effectiveness of a first line 14-day PAM-B therapy and investigate the optimal rescue treatment for the first-line treatment failure. Methods A prospective observational study of Helicobacter pylori eradication was conducted in a single institute. A total of 324 treatment-naïve patients with active H. pylori infections, who were positive for H. pylori between April 2016 and January 2019, were included for analysis. All enrolled patients were treated with 14-day PAM-B therapy (rabeprazole 20 mg, amoxicillin 1 g, metronidazole 750 mg, and tripotassium dicitrato bismuthate 600 mg (elemental bismuth 240 mg twice daily). Six weeks after treatment, H. pylori eradication was assessed. Results Among the 324 participants, 30 patients were lost to follow-up and nine patients consumed less than 80% of prescribed medication. So, the overall eradication rates by intention- to-treat (ITT) and per-protocol (PP) analyses were 83.0% (269/324) and 94.4% (269/285). All 298 patients who received a dose and for whom an outcome measure is available, 19 patients including three patients of low compliance were failed to eradicate H. pylori with PAM-B therapy (modified ITT= 93.6% [279/298]). In 16 patients of treatment failure despite of good compliance, 11 patients were agreed to treat with 2nd line treatment with conventional bismuth-containing quadruple therapy. Among them, eradication rate was 88.9% (8/9) except two follow-up loss patients. Conclusions PAM-B therapy was highly effective as a first line therapy for H. pylori eradication. Conventional bismuth quadruple therapy is thought to be sufficient as a rescue therapy.
- Subjects
SOUTH Korea; HELICOBACTER pylori infections; BISMUTH; LONGITUDINAL method; PATIENT compliance; HELICOBACTER pylori; SCIENTIFIC observation
- Publication
Gut & Liver, 2019, Vol 13, Issue 6(suppl. 1), p124
- ISSN
1976-2283
- Publication type
Article