Tailored susceptibility-guided therapy via gastric juice PCR for the first-line H. pylori eradication, a randomized controlled trial
Background/Purpose: Clarithromycin-based standard triple therapy is still commonly adopted by 81.4% of physicians in real-world practice but yields low eradication rates. Therefore, we conducted this study to compare the efficacy of gastric juice-guided therapy for first-line eradication with the st...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664621004836 |
| _version_ | 1811218757685608448 |
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| author | Meng-Shu Hsieh Fu-Chen Kuo Meng-Chieh Wu Jiunn-Wei Wang Chung-Jung Liu Neng-Sheng Chu Pei-Yun Tsai Ping-I Hsu I-Chen Wu Jeng-Yih Wu Deng-Chyang Wu Fang-Jung Yu Chao-Hung Kuo |
| author_facet | Meng-Shu Hsieh Fu-Chen Kuo Meng-Chieh Wu Jiunn-Wei Wang Chung-Jung Liu Neng-Sheng Chu Pei-Yun Tsai Ping-I Hsu I-Chen Wu Jeng-Yih Wu Deng-Chyang Wu Fang-Jung Yu Chao-Hung Kuo |
| author_sort | Meng-Shu Hsieh |
| collection | DOAJ |
| description | Background/Purpose: Clarithromycin-based standard triple therapy is still commonly adopted by 81.4% of physicians in real-world practice but yields low eradication rates. Therefore, we conducted this study to compare the efficacy of gastric juice-guided therapy for first-line eradication with the standard triple therapy, in order to provide an alternative to real-world practice. Methods: A total of 182 treatment-naïve Hp-infected patients were included and randomly allocated to either susceptibility-guided therapy (SGT) with gastric juice PCR or Clarithromycin-based standard triple therapy (STT) for 7 days. Results: The intention-to-treat eradication rates were 89% (81/91) in SGT and 75.8% in STT (p < 0.031). The per-protocol eradication rates were 91.0% (81/89) in SGT and 79.3% (69/87) in STT (p < 0.034). Among the subgroups of different antibiotic resistance, patients with SGT demonstrated superior eradication rates (91.7% vs 45.5%, p < 0.027) in the subgroup of both clarithromycin resistance and levofloxacin resistance. Conclusion: This prospective randomized controlled trial demonstrated the reliable efficacy of susceptibility-guided therapy via gastric juice PCR for the first-line Hp eradication. In Asia-Pacific area, where standard triple therapy is still adopted by the majority of the physicians, it is a recommended alternative to overcome the increasing antibiotic resistance. |
| first_indexed | 2024-04-12T07:14:47Z |
| format | Article |
| id | doaj.art-2d87e960ff31487aa117dd1fe27a14b9 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-04-12T07:14:47Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-2d87e960ff31487aa117dd1fe27a14b92022-12-22T03:42:30ZengElsevierJournal of the Formosan Medical Association0929-66462022-08-01121814501457Tailored susceptibility-guided therapy via gastric juice PCR for the first-line H. pylori eradication, a randomized controlled trialMeng-Shu Hsieh0Fu-Chen Kuo1Meng-Chieh Wu2Jiunn-Wei Wang3Chung-Jung Liu4Neng-Sheng Chu5Pei-Yun Tsai6Ping-I Hsu7I-Chen Wu8Jeng-Yih Wu9Deng-Chyang Wu10Fang-Jung Yu11Chao-Hung Kuo12Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, TaiwanSchool of Medicine, College of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, TaiwanDepartment of Nursing, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, TaiwanDepartment of Medicine, An Nan Hospital, China Medical University, Tainan, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Corresponding author. Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100Tz-You 1st road, Kaohsiung, 807, Taiwan. Fax: +886 7 3135612.Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Corresponding author. Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital and Kaohsiung Medical University, 100Tz-You 1st road, Kaohsiung, 807, Taiwan. Fax: +886 7 3135612.Background/Purpose: Clarithromycin-based standard triple therapy is still commonly adopted by 81.4% of physicians in real-world practice but yields low eradication rates. Therefore, we conducted this study to compare the efficacy of gastric juice-guided therapy for first-line eradication with the standard triple therapy, in order to provide an alternative to real-world practice. Methods: A total of 182 treatment-naïve Hp-infected patients were included and randomly allocated to either susceptibility-guided therapy (SGT) with gastric juice PCR or Clarithromycin-based standard triple therapy (STT) for 7 days. Results: The intention-to-treat eradication rates were 89% (81/91) in SGT and 75.8% in STT (p < 0.031). The per-protocol eradication rates were 91.0% (81/89) in SGT and 79.3% (69/87) in STT (p < 0.034). Among the subgroups of different antibiotic resistance, patients with SGT demonstrated superior eradication rates (91.7% vs 45.5%, p < 0.027) in the subgroup of both clarithromycin resistance and levofloxacin resistance. Conclusion: This prospective randomized controlled trial demonstrated the reliable efficacy of susceptibility-guided therapy via gastric juice PCR for the first-line Hp eradication. In Asia-Pacific area, where standard triple therapy is still adopted by the majority of the physicians, it is a recommended alternative to overcome the increasing antibiotic resistance.http://www.sciencedirect.com/science/article/pii/S0929664621004836Hp eradicationGastric juiceFirst-line therapy |
| spellingShingle | Meng-Shu Hsieh Fu-Chen Kuo Meng-Chieh Wu Jiunn-Wei Wang Chung-Jung Liu Neng-Sheng Chu Pei-Yun Tsai Ping-I Hsu I-Chen Wu Jeng-Yih Wu Deng-Chyang Wu Fang-Jung Yu Chao-Hung Kuo Tailored susceptibility-guided therapy via gastric juice PCR for the first-line H. pylori eradication, a randomized controlled trial Journal of the Formosan Medical Association Hp eradication Gastric juice First-line therapy |
| title | Tailored susceptibility-guided therapy via gastric juice PCR for the first-line H. pylori eradication, a randomized controlled trial |
| title_full | Tailored susceptibility-guided therapy via gastric juice PCR for the first-line H. pylori eradication, a randomized controlled trial |
| title_fullStr | Tailored susceptibility-guided therapy via gastric juice PCR for the first-line H. pylori eradication, a randomized controlled trial |
| title_full_unstemmed | Tailored susceptibility-guided therapy via gastric juice PCR for the first-line H. pylori eradication, a randomized controlled trial |
| title_short | Tailored susceptibility-guided therapy via gastric juice PCR for the first-line H. pylori eradication, a randomized controlled trial |
| title_sort | tailored susceptibility guided therapy via gastric juice pcr for the first line h pylori eradication a randomized controlled trial |
| topic | Hp eradication Gastric juice First-line therapy |
| url | http://www.sciencedirect.com/science/article/pii/S0929664621004836 |
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