title: Efficacy of a quadruple therapy regimen for Helicobacter pylori eradication after partial gastrectomy.
abstract: We aimed to evaluate the effectiveness and safety of bismuth-containing quadruple therapy plus postural change after dosing for Helicobacter pylori eradication in gastrectomized patients. We compared 76 gastric stump patients with H. pylori infection (GS group) with 50 non-gastrectomized H. pylori-positive patients who met the treatment indication (controls). The GS group was divided into GS group 1 and GS group 2. All groups were administered bismuth potassium citrate (220 mg), esomeprazole (20 mg), amoxicillin (1.0 g), and furazolidone (100 mg) twice daily for 14 days. GS group 1 maintained a left lateral horizontal position for 30 min after dosing. H. pylori was detected using rapid urease testing and histologic examination of gastric mucosa before and 3 months after therapy. Mucosal histologic manifestations were evaluated using visual analog scales of the updated Sydney System. GS group 1 had a higher prevalence of eradication than the GS group 2 (intention-to-treat [ITT]: P=0.025; per-protocol [PP]: P=0.030), and the control group had a similar prevalence. GS group 2 had a lower prevalence of eradication than controls (ITT: P=0.006; PP: P=0.626). Scores for chronic inflammation and activity declined significantly (P<0.001) 3 months after treatment, whereas those for atrophy and intestinal metaplasia showed no significant change. Prevalence of adverse reactions was similar among groups during therapy (P=0.939). A bismuth-containing quadruple therapy regimen plus postural change after dosing appears to be a relatively safe, effective, economical, and practical method for H. pylori eradication in gastrectomized patients.
authors.affiliation: Huadong Hospital, Shanghai Medical College, Division of Gastroenterology, Fudan University, Shanghai, China.
authors.forename: F
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Huadong Hospital, Shanghai Medical College, Division of Gastroenterology, Fudan University, Shanghai, China.
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Bao
authors.affiliation: Huadong Hospital, Shanghai Medical College, Division of Gastroenterology, Fudan University, Shanghai, China.
authors.forename: D M
authors.initials: DM
authors.lastname: Shi
authors.affiliation: Huadong Hospital, Shanghai Medical College, Division of Gastroenterology, Fudan University, Shanghai, China.
authors.forename: P
authors.initials: P
authors.lastname: Xiang
authors.affiliation: Huadong Hospital, Shanghai Medical College, Division of Gastroenterology, Fudan University, Shanghai, China.
authors.forename: L
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Huadong Hospital, Shanghai Medical College, Division of Gastroenterology, Fudan University, Shanghai, China.
authors.forename: Y Q
authors.initials: YQ
authors.lastname: Huang
authors.affiliation: Huadong Hospital, Shanghai Medical College, Division of Gastroenterology, Fudan University, Shanghai, China.
authors.forename: G S
authors.initials: GS
authors.lastname: Zhang
authors.affiliation: Huadong Hospital, Shanghai Medical College, Division of Gastroenterology, Fudan University, Shanghai, China.
authors.forename: S M
authors.initials: SM
authors.lastname: Yin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000379:methods; D064098:Esomeprazole / Q000627:therapeutic use; D005260:Female; D005664:Furazolidone / Q000627:therapeutic use; D005743:Gastrectomy; D018530:Gastric Stump; D016481:Helicobacter Infections / Q000628:therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use; D056888:Patient Positioning / Q000706:statistics & numerical data; D019357:Potassium Citrate / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D009942:Organometallic Compounds; D005664:Furazolidone; D000658:Amoxicillin; D019357:Potassium Citrate; C002791:bismuth tripotassium dicitrate; D064098:Esomeprazole