摘要
BACKGROUND Antibiotic resistance to Helicobacter pylori(H.pylori)infection,which ultimately results in eradication failure,has been an emerging issue in the clinical field.Recently,to overcome this problem,an antibiotic sensitivity-based tailored therapy(TT)for H.pylori infection has received attention.AIM To investigate the efficacy and safety profiles of TT for H.pylori infection treatment compared to a non-bismuth quadruple therapy,concomitant therapy(CT)regimen.METHODS We included patients(>18 years)with an H.pylori infection and without a history of Helicobacter eradication who visited the Gil Medical Center between March 2016 and October 2020.After being randomly assigned to either the TT or CT treatment group in 1 to 1 manner,patient compliance,eradication success rate(ESR),and patient-reported side effects profiles were assessed and compared between the two groups.H.pylori infection was diagnosed using a rapid urease test,Giemsa stain,or dual priming oligonucleotide polymerase chain reaction(DPO-PCR).Tailored eradication strategy based through the presence of a 23S ribosomal RNA point mutation.For the TT group,a DPO-PCR test,which detected A2142G and/or A2143G point mutations,and a clarithromycin resistance test were performed.Patients in the clarithromycin-resistant group were treated with a bismuth-containing quadruple combination therapy,while those with sensitive results were treated with the standard triple regimen.RESULTS Of the 217 patients with a treatment naive H.pylori infection,110 patients[mean age:58.66±13.03,men,n=55(50%)]were treated with TT,and 107 patients[mean age:56.67±10.88,men,n=52(48.60%)]were treated with CT.The compliance(TT vs CT,100%vs 98.13%,P=0.30),and follow-up loss rates(8.18%vs 9.35%,P=0.95)were not significantly different between the groups.The ESR after treatment was also not statistically different between the groups(TT vs CT,82.73%vs 82.24%,P=0.95).However,the treatment-related and patient-reported side effects were significantly lower in the TT group than in the CT gr
基金
National Research Foundation of Korea(NRF)funded by the Ministry of Education,No.NRF-2020R1F1A1076839。
