Tailored eradication vs empirical bismuth-containing quadruple therapy for first-line Helicobacter pylori eradication: A comparative, open trial
- Authors
- Choi, Youn I.; Chung, Jun Won; Park, Dong Kyun; Kim, Kyoung Oh; Kwon, Kwang An; Kim, Yoon Jae; Seo, Ja Young
- Issue Date
- 14-Dec-2019
- Publisher
- BAISHIDENG PUBLISHING GROUP INC
- Keywords
- Helicobacter pylori; Eradication; Tailored; Empirical; Quadruple
- Citation
- WORLD JOURNAL OF GASTROENTEROLOGY, v.25, no.46, pp.6743 - 6751
- Journal Title
- WORLD JOURNAL OF GASTROENTEROLOGY
- Volume
- 25
- Number
- 46
- Start Page
- 6743
- End Page
- 6751
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/26467
- DOI
- 10.3748/wjg.v25.i46.6743
- ISSN
- 1007-9327
- Abstract
- BACKGROUND Few studies have compared the efficacy and safety profile of a tailored eradication (TR) strategy based on the presence of a 23S ribosomal RNA point mutation with those of empirical bismuth-based quadruple therapy (EBQT) for first-line eradication of Helicobacter pylori (H. pylori) in Korean patients. AIM To compare the efficacy and safety of a TR strategy and those of EBQT regimen as first-line eradication therapy for H. pylori. METHODS This is an open-label, comparative study in which we prospectively enrolled patients over 18 years of age with H. pylori infection and retrospectively reviewed their data. H. pylori-positive patients diagnosed by rapid urease test, Giemsa staining, or dual priming oligonucleotide polymerase chain reaction (DPO-PCR) were enrolled from May 2016 to September 2018 at Gil Medical Center. Patients with H. pylori infection received either a TR regimen or the EBQT regimen. In the tailored therapy group that underwent DPO-PCR testing, patients with A2142G and/or A2143G point mutations were treated with a bismuth-containing quadruple regimen. The eradication rate, patient-reported side effect rate, and H. pylori eradication success rate were evaluated and compared between the groups. RESULTS A total of 150 patients were assigned to the TR (n = 50) or EBQT group (n = 100). The first-line eradication rate of H. pylori did not differ between the groups (96.0% vs 95.7%, P = 0.9). The rate of eradication-related side effects for TR was 12.0%, which differed significantly from that of EBQT (43.0%) for first-line treatment (P < 0.001). CONCLUSION DPO-PCR-based TR for H. pylori eradication may be equally efficacious, with less treatment-related complications, compared to EBQT in Korea, where clarithromycin resistance is high.
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