Tailored Helicobacter pylori therapy is more effective than conventional therapy: a randomized-controlled trial
Abstract
Background and aims Tailored (culture and sensitivity) therapy has gained attention over recent years as an effective option for eradication of Helicobacter pylori infection. The authors aimed to assess the efficacy of antibiotics sensitivity-guided therapy versus clarithromycin or levofloxacin triple therapies as the first-line therapy for H. pylori. Patients and methods Dyspeptic patients who underwent esophagogastroduodenoscopy were prospectively enrolled. Patients with positive H. pylori results by the rapid urease test were randomized to receive either antibiotics sensitivity-guided therapy or empirical clarithromycin or levofloxacin-based triple therapy for 14 days. Antimicrobial sensitivity tests for seven antibiotics (clarithromycin, amoxicillin, metronidazole, levofloxacin, tetracycline, nitrofurantoin, and rifampicin) were performed using the disk-diffusion method. Group A received antibiotics sensitivity-guided therapies that included esomeprazole plus two antibiotics for which the isolates were sensitive and group B received conventional therapies that included esomeprazole, amoxicillin plus clarithromycin or levofloxacin for 2 weeks. Eradication of H. pylori was checked using stool antigen 4 weeks after therapy. Results A total of 25 patients completed the study in each group. Both studied groups were matched for baseline characteristics. The most commonly used regimen in the antimicrobial sensitivity-based therapy was clarithromycin-based triple therapy…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 25 participants or records.
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