Journal
PATHOGENS
Volume 11, Issue 12, Pages -Publisher
MDPI
DOI: 10.3390/pathogens11121549
Keywords
Helicobacter pylori; antibiotic resistance; doxycycline; eradication; safety; penicillin allergy
Categories
Funding
- National Natural Science Foundation of China
- Changsha Municipal Natural Science Foundation [81570509]
- Scientific Research Project of Hunan Provincial Health Commission [kq2014257]
- [202103031034]
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This study aimed to compare the efficacy and safety of doxycycline and amoxicillin in the first-line treatment of H. pylori-infected duodenal ulcers. The results showed that both treatments were effective and safe in H. pylori eradication, ulcer healing, and symptom relief. Only a small number of participants experienced adverse effects.
Background: Increased antibiotic resistance is one of the major factors contributing to the failure of H. pylori eradication. This study aimed to compare the efficacy and safety of doxycycline and amoxicillin, both critical components for bismuth-based quadruple therapy, for the first-line treatment of H. pylori-infected duodenal ulcers. Methods: An open, randomized case-controlled, multicenter trial was conducted in seven hospitals in China. A total of 184 eligible participants were divided into an IDFB (ilaprazole 5 mg, doxycycline 100 mg, furazolidone 100 mg, and bismuth 220 mg bid) or IAFB (ilaprazole 5 mg, amoxicillin 1000 mg, furazolidone 100 mg, and bismuth 220 mg bid) group for 14 days. Both groups were administrated with ilaprazole 5 mg qd for another 14 days. The main outcome was an H. pylori eradication rate; secondary outcomes were ulcer healing, relief of symptoms, and incidence of adverse effects. Results: The H. pylori eradication rates were 85.9% (95% CI 78.6-93.9) in the IDFB vs. 84.8% (95% CI 77.3-92.3) in the IAFB group in ITT analysis (p > 0.05), and 92.9% (95% CI 87.4-98.5) vs. and 91.8% (95% CI 85.8-97.7) in PP analysis (p > 0.05). The overall ulcer healing rates of IDFB and IAFB were 79.1% and 84.7% (p > 0.05), both effective in relieving symptoms. Only nine participants had adverse reactions in this trial (4/92 in IDFB and 5/92 in IAFB). Conclusion: A bismuth quadruple regimen containing doxycycline or amoxicillin could be an effective and safe treatment for H. pylori eradication, while doxycycline replacement is an alternative for participants with penicillin allergy.
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