Naslov
Randomized clinical trial comparing concomitant and tailored therapy for eradication of Helicobacter pylori infection

Autori
Perković, Nikola ; Meštrović, Antonio ; Božić, Joško ; Pavičić Ivelja, Mirela ; Vuković, Jonatan ; Kardum, Goran ; Šundov, Željko ; Tonkić, Marija ; Puljiz, Željko ; Vukojević, Katarina ; Tonkić, Ante

Izvornik
Journal of personalized medicine (2075-4426) 11 (2021), 6; 534, 10

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
H. pylori ; concomitant therapy ; tailored therapy ; gastritis ; antimicrobial resistance

Sažetak
As high clarithromycin resistance (>20%) in the Split-Dalmatia region of Croatia hinders the treatment of H. pylori infection, the primary objective of this study was to compare concomitant quadruple with the tailored, personalized therapy as first-line eradication treatment of H. pylori. In an open-label, randomized clinical trial, 80 patients with H. pylori infection were randomly assigned to either concomitant (esomeprazole 40 mg, amoxicillin 1 gr, metronidazole 500 mg, clarithromycin 500 mg, twice daily for 14 days) or tailored therapy in accordance with the results of the antimicrobial susceptibility testing. Eradication status was assessed 4 weeks after treatment. Eradication rates were significantly higher in tailored group than in concomitant group both in intention-to- treat (70 vs. 92.5%, p = 0.010) and per-protocol (87.5 vs. 100%, p = 0.030) analysis in the setting of increasing antibiotic resistance (clarithromycin 37.5%, metronidazole 17.5%, dual resistance 10%). Adverse effects were more frequent in the concomitant group (32.5 vs. 7.5%, p = 0.006). Tailored therapy achieves higher eradication with a lower adverse events rate. With the increasing resistance of H. pylori strains to antibiotic treatment, eradication regimes with such characteristics should be strongly considered as a reasonable choice for first- line treatment.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA