The application value of the quadruple therapy regimen containing bismuth,Mino-cycline and Clarithromycin in the initial treatment patients with Helicobacter pylori infection allergic to penicillin
Objective To evaluate the eradication efficacy,compliance and safety of the bismuth quadruple regimen containing Minocycline and Clarithromycin in the initial treatment of H.pylori infection among patients with penicillin al-lergy.Methods This study used a retrospective analysis to collect clinical data of 219 patients with H.pylori infection allergic to penicillin treated at the First Hospital of Tsinghua University from Sep.2022 to Jul.2023.Group RMiCB(69 cases)received a regimen of Rabeprazole,Minocycline,Clarithromycin and compound bismuth aluminate granules.Group RMeCB(71 cases)received the regimen of Rabeprazole,Metronidazole,Clarithromycin and compound bismuth aluminate granules.Group RLCB(79 cases)was treated with a regimen of Rabeprazole,Levofloxacin,Clarithromycin and compound bismuth aluminate granules.The treatment courses were all 14 days,and telephone follow-up was con-ducted to assess patient safety,compliance and H.pylori eradication.Results There was no significant difference in baseline data among the three groups(P>0.05).According to the intention-to-treat analysis(ITT),the H.pylori eradi-cation rates were 86.9%(60/69)in group RMiCB,60.5%(43/71)in group RMeCB,and 62.0%(49/79)in group RLCB;the per-protocol analysis(PP)showed that the rates were 90.9%(60/66)in group RMiCB,66.2%(43/65)in group RMeCB,and 68.1%(49/72)in group RLCB.According to the PP analysis,the H.pylori eradication rate in group RMiCB was higher than that in group RMeCB and group RLCB,with a statistically significant difference(χ2=13.428,P=0.001),while there was no statistical difference in the H.pylori eradication rates between group RMeCB and group RLCB(χ2=0.056,P=0.857).The incidence of drug adverse reactions was 13.0%(9/69)in group RMiCB,16.9%(12/71)in group RMeCB,and 16.5%(13/79)in group RLCB,with no significant difference(χ2=0.479,P=0.797).Conclusion The quadruple therapy regimen containing Bismuth,Minocycline,and Clarithromy-cin is effective in eradicating H.pylori infection among patients with penicillin allergy in initial treatment,has high com-pliance,and can be considered as an alternative treatment option.
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