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Article

Seven Days of Bismuth-Based Quadruple Therapy Is as Effective for the First-Line Treatment of Clarithromycin-Resistant Confirmed Helicobacter pylori Infection as 14 Days of Bismuth-Based Quadruple Therapy

by
Sang-Gon Moon
1,
Chul-Hyun Lim
1,*,
Hee-Jun Kang
1,
Arum Choi
2,
Sukil Kim
2 and
Jung-Hwan Oh
1
1
Division of Gastroenterology, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul 03312, Korea
2
Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2022, 11(15), 4440; https://doi.org/10.3390/jcm11154440
Submission received: 30 June 2022 / Revised: 25 July 2022 / Accepted: 28 July 2022 / Published: 30 July 2022
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
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Abstract

Background/Aims: Point mutations in the 23S ribosomal RNA gene have been associated with Helicobacter pylori (H. pylori) clarithromycin resistance and bismuth-based quadruple therapy (BQT) is one of the options for the treatment of clarithromycin-resistant H. pylori. Current H. pylori treatment guidelines recommend BQT for 10–14 days. This study aims to compare the eradication extents according to 7-day and 14-day BQT treatment for treatment-naïve clarithromycin-resistant confirmed H. pylori infection. Methods: We retrospectively investigated treatment-naïve H. pylori infection cases from March 2019 to December 2020, where patients were treated with BQT. Clarithromycin resistance was identified with a dual-priming oligonucleotide-based multiplex polymerase chain reaction method. We reviewed a total of 126 cases. Fifty-three subjects were treated with a 7-day BQT regimen (7-day group), and 73 subjects were treated with a 14-day BQT regimen (14-day group). We evaluated the total eradication extent of the BQT and compared the eradication extents of the two study groups. Results: Total eradication extent of H. pylori was 83.3% (105/126). The eradication extents of the two groups were as follows: 7-day group (81.1% (43/53)), 14-day group (84.9% (62/73), p = 0.572) by intention-to-treat analysis; 7-day group (95.6% (43/45)), 14-day group (92.5% (62/67), p = 0.518) by per-protocol analysis. The moderate or severe adverse event extents during the eradication were 30.2% (16/53) in the 7-day group and 19.2% (14/73) in the 14-day group (p = 0.152). Conclusions: The 7-day BQT regimen was as effective as the 14-day BQT regimen in the eradication of treatment-naïve clarithromycin-resistant H. pylori infection.
Keywords: Helicobacter pylori; clarithromycin; bismuth; duration of therapy; point mutation Helicobacter pylori; clarithromycin; bismuth; duration of therapy; point mutation

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MDPI and ACS Style

Moon, S.-G.; Lim, C.-H.; Kang, H.-J.; Choi, A.; Kim, S.; Oh, J.-H. Seven Days of Bismuth-Based Quadruple Therapy Is as Effective for the First-Line Treatment of Clarithromycin-Resistant Confirmed Helicobacter pylori Infection as 14 Days of Bismuth-Based Quadruple Therapy. J. Clin. Med. 2022, 11, 4440. https://doi.org/10.3390/jcm11154440

AMA Style

Moon S-G, Lim C-H, Kang H-J, Choi A, Kim S, Oh J-H. Seven Days of Bismuth-Based Quadruple Therapy Is as Effective for the First-Line Treatment of Clarithromycin-Resistant Confirmed Helicobacter pylori Infection as 14 Days of Bismuth-Based Quadruple Therapy. Journal of Clinical Medicine. 2022; 11(15):4440. https://doi.org/10.3390/jcm11154440

Chicago/Turabian Style

Moon, Sang-Gon, Chul-Hyun Lim, Hee-Jun Kang, Arum Choi, Sukil Kim, and Jung-Hwan Oh. 2022. "Seven Days of Bismuth-Based Quadruple Therapy Is as Effective for the First-Line Treatment of Clarithromycin-Resistant Confirmed Helicobacter pylori Infection as 14 Days of Bismuth-Based Quadruple Therapy" Journal of Clinical Medicine 11, no. 15: 4440. https://doi.org/10.3390/jcm11154440

APA Style

Moon, S.-G., Lim, C.-H., Kang, H.-J., Choi, A., Kim, S., & Oh, J.-H. (2022). Seven Days of Bismuth-Based Quadruple Therapy Is as Effective for the First-Line Treatment of Clarithromycin-Resistant Confirmed Helicobacter pylori Infection as 14 Days of Bismuth-Based Quadruple Therapy. Journal of Clinical Medicine, 11(15), 4440. https://doi.org/10.3390/jcm11154440

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