You are here

  • Home
  • Archive
  • Volume 68, Issue Suppl 1
  • IDDF2019-ABS-0146 Efficacies of tailored therapy versus guideline-recommended empiricaltherapies for eradication of helicobacter pylori – a trend survey over 20 years in taiwan (1999–2018)

Article Text

Article menu

Download PDFPDF

Clinical Gastroenterology
IDDF2019-ABS-0146 Efficacies of tailored therapy versus guideline-recommended empiricaltherapies for eradication of helicobacter pylori – a trend survey over 20 years in taiwan (1999–2018)
Free
  1. Chien-Chih Tung1,
  2. Chi-Tan Hu,
  3. Chun-Jung Lin3,
  4. I-Nan Kuo4,
  5. Bor-Ru Lin1,
  6. Hong-Long Wang5,
  7. Jin-De Chen6,
  8. Mu-Liang Cheng7,
  9. Chia-Tung Shun1,
  10. Huei-Mi Li3,
  11. Jui-Sheng Hung2,
  12. Wei-Yi Lei2,
  13. Ming-Jium Shieh1,
  14. Jau-Min Wong1,
  15. John Yung-Chong Kao8
  1. 1National Taiwan University Hospital, Taiwan
  2. 2Buddhist Tzu Chi General Hospital, Taiwan
  3. 3School of Pharmacy, National Taiwan University, Taiwan
  4. 4National Taiwan University Hospital Hsin-Chu Branch, Taiwan
  5. 5Department of Statistics, National Taipei University, Taiwan
  6. 6National Taiwan University Hospital Bei-Hu Branch, Taiwan
  7. 7Mennonite Christian Hospital, Taiwan
  8. 8University of Michigan, USA

Abstract

Background The empiric therapies for H. pylori infection in clinical guidelines have been widely used. However, the cure rate is decreasing due to the increase of antibiotic resistance. The importance of antimicrobial susceptibility test (AST) has been documented in many consensuses. However, the effect of tailored therapy remains controversial because the AST is rarely offered in most areas. We compared the evolution of treatment efficacy among tailored therapy and some recommended empiric therapies through a trend survey from 1999 to 2018.

Methods This retrospective survey was performed at 2 medical centers and 3 community hospitals in Taiwan. A total of 16,370 treatment naive or failure patients were recruited. Successful H. pylori eradication was defined as a negative 13C-UBT. The empiric first-line regimens include tailored therapy, clarithromycin-containing triple therapy (CLA-TT), sequential therapy (ST), bismuth-containing quadruple therapy (BQT), and high-dose dual therapy (HDDT). The empiric rescue regimens include tailored therapy, levofloxacin-containing triple therapy (LEV-TT), BQT, and HDDT. We divided the 20 years of follow-up time into 4-year periods for evaluating the trend of treatment efficacies. The E-test was performed to evaluate H. pylori resistance. For the tailored therapy, CLA-TT, LEV-TT, BQT, or HDDT was chosen according to the resistance pattern of each patient.

Results The efficacies of tailored therapy, BQT, and HDDT maintain a stable and high efficacy in both first-line and rescue treatment during the study period. However, the efficacies of CLA-TT, ST, and LEV-TT are decreasing year by year. The eradication rate of tailored therapy is significantly higher than that of CLA-TT, ST, LEV-TT, and BQT in recent 4-year period. However, there is no significant difference between the efficacy of tailored therapy and HDDT. The prevalence of H. pylori resistance to CLA and LEV increased gradually. In contrast, the resistance rate to amoxicillin and tetracycline remained low.

Conclusions Over the past 20 years, we found that the efficacy of tailored therapy remains relatively stable. Of the recommended empiric therapies, HDDT and BQT have stable therapeutic efficacies and are a good choice of empiric treatment currently.

https://doi.org/10.1136/gutjnl-2019-IDDFAbstracts.166

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.