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    Title: Hybrid vs sequential therapy for eradication of Helicobacter pylori in Taiwan: A prospective randomized trial
    Authors: Chen, Kuan-Yang;Lin, Tsung-Jung;Lin, Chin-Lin;Lee, Hsi-Chang;Wang, Chung-Kwe;Wu, Deng-Chyang
    陳冠仰
    Contributors: 神經科學研究所
    Keywords: amoxicillin;clarithromycin;metronidazole;rabeprazole;urea c 13;amoxicillin;antiinfective agent;clarithromycin;metronidazole;proton pump inhibitor;rabeprazole;abdominal pain;adult;anorexia;antibiotic resistance;Article;bacterium culture;bitter taste;breath analysis;constipation;controlled study;diarrhea;dizziness;drug efficacy;drug treatment failure;endoscopy;eradication therapy;fatigue;female;follow up;headache;Helicobacter infection;Helicobacter pylori;histology;human;hybrid therapy;intention to treat analysis;major clinical study;male;medication compliance;nausea;patient compliance;prospective study;randomized controlled trial;rapid urease test;rash;risk factor;sequential therapy;side effect;Taiwan;treatment duration;treatment outcome;vomiting;aged;combination drug therapy;comparative study;drug effects;Helicobacter Infections;Helicobacter pylori;microbiology;middle aged;time factor;Adult;Aged;Amoxicillin;Anti-Bacterial Agents;Clarithromycin;Drug Therapy, Combination;Female;Helicobacter Infections;Helicobacter pylori;Humans;Intention to Treat Analysis;Male;Metronidazole;Middle Aged;Prospective Studies;Proton Pump Inhibitors;Rabeprazole;Taiwan;Time Factors;Treatment Outcome
    Date: 2015-09
    Issue Date: 2017-08-07 17:41:18 (UTC+8)
    Abstract: AIM: To evaluate the efficacy of sequential vs hybrid therapy in patients with Helicobacter pylori (H. pylori ) infection. METHODS: From March 2013 to May 2014, one hundred and seventy-five H. pylori infected patients who had not been treated for H. pylori before were randomized to receive either sequential therapy (rabeprazole 20 mg and amoxicillin 1 g twice daily for 5 d, followed by rabeprazole 20 mg, clarithromycin 500 mg and metronidazole 500 mg twice daily for 5 d) or hybrid therapy (rabeprazole 20 mg and amoxicillin 1 g for 7 d, followed by rabeprazole 20 mg, amoxicillin 1 g, clarithromycin 500 mg and metronidazole 500 mg twice daily for 7 d). H. pylori status was confirmed by positive results of both rapid urease test and histology examination or a positive result of culture. Eradication efficacy was assessed by follow-up endoscopy with rapid urease test and histological examination 8 wk after the end of anti-H. pylori therapy, or 13C-urea breath test at least 4 wk after completion of treatment. The primary outcome was H. pylori eradication by intension-to-treat (ITT) and per-protocol (PP) analyses. RESULTS: One hundred and sixty-seven patients (83 patients in the sequential group and 84 patients in the hybrid group) completed the study. The compliance rates were 97.6% and 97.7% for the two groups, respectively. The eradication rate was 78.2% for the sequential group and 92% for the hybrid group by ITT analysis (p = 0.01). The eradication rate was 81.9% for the sequential group and 96.4% for the hybrid group by PP analysis (p = 0.01). Univariate analysis for the clinical and bacterial factors did not identify any risk factors associated with treatment failure. Severe adverse events were observed in 2.3% of patients in the sequential group and 2.4% of those in the hybrid group. CONCLUSION: Due to a grade A (> 95%) success rate for H. pylori eradication by PP analysis, similar compliance and adverse events, hybrid therapy seems to be an appropriate eradication regimen in Taiwan. © The Author(s) 2015.
    Relation: World Journal of Gastroenterology, 21(36), 10435-10442
    Data Type: article
    DOI 連結: http://dx.doi.org/10.3748/wjg.v21.i36.10435
    DOI: 10.3748/wjg.v21.i36.10435
    Appears in Collections:[神經科學研究所 ] 期刊論文

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