雷贝拉唑、阿莫西林、加替沙星三联疗法根除幽门螺杆菌的疗效及安全性

目的:评价由加替沙星(400 mg,qd),雷贝拉唑(20 mg,bid),阿莫西林(1 g,bid),疗程7 d的三联方案根除治疗幽门螺杆菌的疗效及安全性。方法:48名幽门螺杆菌感染的患者参与本次研究,受试者均有一次或一次以上含克拉霉素的常规三联治疗史。治疗后四周通过14 C-呼气试验判定根除治疗效果。根除治疗失败的患者通过体外抑菌试验判断幽门螺杆菌对阿莫西林,克拉霉素及加替沙星的药物敏感性。结果:41名患者根除治疗成功[完成治疗分析(PP)和意向治疗分析(ITT)均为85.4%,95%CI:74%～95%]无显著副作用。体外药敏试验显示在7名治疗失败的患者中未出现对加替沙星和阿莫西林的继发耐药。结论:由加替沙星、阿莫西林和雷贝拉唑组成的7 d短程治疗方案,作为根除治疗失败后的补救治疗方案简单有效,耐受性好,依从性高;而且此方案失败后未引起继发耐药性。

Efficacy and safety of a triple therapy for the eradication of Helicobacter pylori with rabeprazole,amoxicillin,and gatifloxacin

OBJECTIVE To evaluate the efficacy and safety of a 7-day therapeutic regimen of gatifloxacin(400mg daily),rabeprazole(20mg twice a day),and amoxicillin(1g twice a day) in patients with Helicobacter pylori(H.pylori) infection.METHODS Forty-eight patients with Helicobacter pylori infection following one or more conventional clarithromycin-containing triple therapies were enrolled in this study.A cure check was performed 4 weeks after conclusion of therapy by 14C-urea breath test.Culture of H.pylori and susceptibility testing to clarithromycin,amoxicillin,and gatifloxacin was done in case of failed eradication.RESULTS Forty-one patients [both per-protocol(PP) and intention-to-treat analysis(ITT): 85.4%;95% CI:74%~95%] were treated successfully.None of the patients discontinued treatment prematurely due to adverse events.In vitro susceptibility testing showed no secondary resistance to gatifloxacin or amoxicillin in any of seven non-responders.CONCLUSION The 7-day therapeutic regimen of gatifloxacin,rabeprazole,and amoxicillin is effective,simple,well tolerated,and may lead to higher compliance.The regimen dose not appear to result in secondary resistance after failed eradication therapy for H.pylori.