Helicobacter pylori:High dose amoxicillin does not improve primary or secondary eradication rates in an Irish cohort  

作　　者：Conor Costigan Aoife M O'Sullivan Jim O'Connell Shreyashee Sengupta Thomas Butler Stephen Molloy Fintan John O'Hara Barbara Ryan Niall Breslin Sarah O'Donnell Anthony O'Connor Sinead Smith Deirdre McNamara 

机构地区：[1]Trinity Academic Gastroenterology Group,School of Medicine-Trinity College Dublin,Dublin D2,Ireland [2]Department of Gastroenterology,Tallaght University Hospital,Dublin D24 NR0A,Ireland

出　　处：《World Journal of Clinical Cases》2024年第16期2773-2779,共7页世界临床病例杂志

摘　　要：BACKGROUND Helicobacter pylori(H.pylori)eradication rates have fallen globally,likely in large part due to increasing antibiotic resistance to traditional therapy.In areas of high clarithromycin and metronidazole resistance such as ours,Maastricht VI guidelines suggest high dose amoxicillin dual therapy(HDADT)can be considered,subject to evidence for local efficacy.In this study we assess efficacy of HDADT therapy for H.pylori eradication in an Irish cohort.AIM To assess the efficacy of HDADT therapy for H.pylori eradication in an Irish cohort as both first line,and subsequent therapy for patients diagnosed with H.pylori.METHODS All patients testing positive for H.pylori in a tertiary centre were treated prospectively with HDADT(amoxicillin 1 g tid and esomeprazole 40 mg bid×14 d)over a period of 8 months.Eradication was confirmed with Urea Breath Test at least 4 wk after cessation of therapy.A delta-over-baseline>4%was considered positive.Patient demographics and treatment outcomes were recorded,analysed and controlled for basic demographics and prior H.pylori treatment.RESULTS One hundred and ninety-eight patients were identified with H.pylori infection,10 patients were excluded due to penicillin allergy and 38 patients refused follow up testing.In all 139 were included in the analysis,55%(n=76)were female,mean age was 46.6 years.Overall,93(67%)of patients were treatment-naïve and 46(33%)had received at least one previous course of treatment.The groups were statistically similar.Self-reported compliance with HDADT was 97%,mild side-effects occurred in 7%.There were no serious adverse drug reactions.Overall the eradication rate for our cohort was 56%(78/139).Eradication rates were worse for those with previous treatment[43%(20/46)vs 62%(58/93),P=0.0458,odds ratio=2.15].Age and Gender had no effect on eradication status.CONCLUSION Overall eradication rates with HDADT were disappointing.Despite being a simple and possibly better tolerated regime,these results do not support its routine use in a high dual resista

关 键 词：Helicobacter pylori eradication Helicobacter pylori High dose amoxicillin High dose amoxicillin dual therapy Triple therapy 

分 类 号：R573[医药卫生—消化系统] R735.2[医药卫生—内科学]