PMID- 26185386 OWN - NLM STAT- MEDLINE DCOM- 20160322 LR - 20220409 IS - 2219-2840 (Electronic) IS - 1007-9327 (Print) IS - 1007-9327 (Linking) VI - 21 IP - 26 DP - 2015 Jul 14 TI - Fourteen- vs seven-day bismuth-based quadruple therapy for second-line Helicobacter pylori eradication. PG - 8132-9 LID - 10.3748/wjg.v21.i26.8132 [doi] AB - AIM: To compare the efficacy of 14- and 7-d bismuth-based quadruple therapies as second-line eradication treatment for Helicobacter pylori (H. pylori) infection. METHODS: Between 2004 and 2014, the medical records of 790 patients who had experienced failure of first-line proton pump inhibitor (PPI)-based eradication therapy and were then treated with bismuth-based quadruple therapy were retrospectively reviewed. Those who received bismuth-based quadruple therapy [PPI, bismuth, metronidazole, and tetracycline (PBMT)] for either 7 d or 14 d were assigned to a PBMT-7 group (n = 543) or a PBMT-14 group (n = 247), respectively. The eradication rates for both groups were determined by intention-to-treat (ITT) and per-protocol (PP) analyses. ITT analysis compared the treatment groups as originally allocated while the PP analysis including only those patients who had completed the treatment as originally allocated. Successful eradication therapy for H. pylori infection was defined as a negative (13)C-urea breath test 4 wk after the end of eradication treatment. RESULTS: The overall ITT eradication rate was 69.1% (546/790). Final ITT eradication rates were 67.4% (366/543; 95%CI: 63.1%-71.7%) in the PBMT-7 group and 72.8% (180/247; 95%CI: 67.4%-78.2%) in the PBMT-14 group (P = 0.028). The overall PP eradication rate was 80.0% (546/682), and the final PP eradication rates were 78.2% (366/468; 95%CI: 72.1%-84.0%) in the PBMT-7 group and 84.1% (180/214; 95%CI: 76.8%-90.8%) in the PBMT-14 group (P = 0.009). The H. pylori eradication rates in the PBMT-14 group were significantly higher than in the PBMT-7 group according to both ITT (P = 0.028) and PP analysis (P = 0.009). Compliance was similar in both groups (PBMT-7 group: 97.9%; PBMT-14 group: 96.4%). Adverse event rates were 10.7% (51/478) and 17.1% (38/222) in the PBMT-7 and PBMT-14 groups, respectively (P = 0.487). CONCLUSION: The 14-d bismuth-based quadruple therapy is a significantly more effective second-line eradication treatment for H. pylori infection than the 7-d alternative. FAU - Hwang, Jae Jin AU - Hwang JJ AD - Jae Jin Hwang, Dong Ho Lee, Ae-Ra Lee, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea. FAU - Lee, Dong Ho AU - Lee DH AD - Jae Jin Hwang, Dong Ho Lee, Ae-Ra Lee, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea. FAU - Lee, Ae-Ra AU - Lee AR AD - Jae Jin Hwang, Dong Ho Lee, Ae-Ra Lee, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea. FAU - Yoon, Hyuk AU - Yoon H AD - Jae Jin Hwang, Dong Ho Lee, Ae-Ra Lee, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea. FAU - Shin, Cheol Min AU - Shin CM AD - Jae Jin Hwang, Dong Ho Lee, Ae-Ra Lee, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea. FAU - Park, Young Soo AU - Park YS AD - Jae Jin Hwang, Dong Ho Lee, Ae-Ra Lee, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea. FAU - Kim, Nayoung AU - Kim N AD - Jae Jin Hwang, Dong Ho Lee, Ae-Ra Lee, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea. LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - World J Gastroenterol JT - World journal of gastroenterology JID - 100883448 RN - 0 (Anti-Bacterial Agents) RN - 0 (Organometallic Compounds) RN - 0 (Proton Pump Inhibitors) RN - 140QMO216E (Metronidazole) RN - 32828355LL (Rabeprazole) RN - F8VB5M810T (Tetracycline) RN - HS813P8QPX (bismuth tripotassium dicitrate) RN - N3PA6559FT (Esomeprazole) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Anti-Bacterial Agents/*administration & dosage/adverse effects MH - Breath Tests MH - Drug Administration Schedule MH - Drug Therapy, Combination MH - Esomeprazole/administration & dosage MH - Female MH - Helicobacter Infections/diagnosis/*drug therapy/microbiology MH - Helicobacter pylori/*drug effects/pathogenicity MH - Humans MH - Intention to Treat Analysis MH - Male MH - Medical Records MH - Medication Adherence MH - Metronidazole/administration & dosage MH - Middle Aged MH - Organometallic Compounds/*administration & dosage/adverse effects MH - Proton Pump Inhibitors/*administration & dosage/adverse effects MH - Rabeprazole/administration & dosage MH - Remission Induction MH - Retrospective Studies MH - Tetracycline/administration & dosage MH - Time Factors MH - Treatment Outcome PMC - PMC4499357 OTO - NOTNLM OT - Bismuth OT - Eradication rate OT - Helicobacter pylori OT - Second-line treatment OT - Treatment failure EDAT- 2015/07/18 06:00 MHDA- 2016/03/24 06:00 PMCR- 2015/07/14 CRDT- 2015/07/18 06:00 PHST- 2014/12/30 00:00 [received] PHST- 2015/02/05 00:00 [revised] PHST- 2015/03/18 00:00 [accepted] PHST- 2015/07/18 06:00 [entrez] PHST- 2015/07/18 06:00 [pubmed] PHST- 2016/03/24 06:00 [medline] PHST- 2015/07/14 00:00 [pmc-release] AID - 10.3748/wjg.v21.i26.8132 [doi] PST - ppublish SO - World J Gastroenterol. 2015 Jul 14;21(26):8132-9. doi: 10.3748/wjg.v21.i26.8132.