Application of Minocycline-Containing Bismuth Quadruple Therapies as First-Line Regimens in the Treatment of Helicobacter pylori. (18th December 2019)

• Record Type: Journal Article
• Authors: Zhang, Lingyun; Lan, Yu; Wang, Qi; Zhang, Yuexia; Si, Xiaobei
• Other Names: Chirletti Piero Academic Editor.
• Is Part Of: Gastroenterology research and practice. Volume 2019(2019)
• Publication Date: 2019-12-18
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33005
• DOI: 10.1155/2019/9251879
• Languages: English
• ISSNs: 1687-6121

Abstract

Abstract : Aim . To evaluate the eradication rate, safety, and compliance of minocycline-containing bismuth quadruple regimens in patients with an untreated Helicobacter pylori ( H. pylori ) infection. Methods . A total of 360 patients with an untreated H. pylori infection were enrolled in this study between June 2017 and October 2018. Patients were randomly divided into a minocycline/amoxicillin (RMAB) group, a minocycline/metronidazole (RMMB) group, or an amoxicillin/clarithromycin (RACB) group, and all groups received a combined treatment approach with rabeprazole and bismuth to create a quadruple regimen for 14 days. A 3 to 5-day follow-up was adopted to evaluate the safety and compliance of medications after medicine administration. 13 C-urea breath test was performed to confirm the eradication of H. pylori 4-12 weeks after therapy. Results. No significant differences were observed at baseline data among the three groups (p > 0.05 ). Based on the intent-to-treat analysis, the eradication rates of the RMAB group, RMMB group, and RACB control group were 85.7% (102/119), 77.1% (91/118), and 71.7% (86/120), respectively, with significant difference (χ 2 = 7.015, p = 0.030 ). According to per protocol analysis, the eradication rates of RMAB group, RMMB group, and RACB group were 89.5% (102/114), 84.3% (91/108), and 76.8% (86/112), respectively, with statistically significant differences (χ 2 = 6.673, p = 0.036 ). The eradication rates of the RMAB group and RACB group were significantly different (p < 0.05 ). The overall incidences of adverse events in the three groups were 30.0%, 37.5%, and 40.0%, respectively (p > 0.05 ). Nausea, epigastric discomfort, and dizziness were more obvious in patients in the RMMB group compared to the other two groups (p < 0.05 ). Moreover, two patients discontinued due to severe dizziness and nausea in the RMMB group. A taste disorder was more prominent in patients in the RACB group compared to patients in the other two groups (p < 0.05 ), and one patient discontinued because of the bitterness in the mouth. Soon after discontinuation of the medicine, all adverse events disappeared . Conclusion. The bismuth quadruple regimen using minocycline/amoxicillin showed a better eradication effect with fewer side effects in patients with untreated H. pylori infections. The bismuth quadruple regimen with minocycline/metronidazole had a good eradication effect with more obvious side effects and might be recommended to patients with penicillin allergy.