Efficacy of a multistep strategy for XXXX eradication.

@entity1 @entity115 @entity7015 @entity4581 @entity344 @entity281 @entity1535 @entity1534 @entity11450
BACKGROUND: @entity1534 eradication therapies do not achieve 100% success rates. Antibiotic resistant strains are among the major causes of failure. Current recommendations concerning the management of treatment failures are not fully clear. AIM: To evaluate the efficacy of a multi-step therapeutic strategy in a large group of infected @entity1 . METHODS: A total of 2606 @entity1534 -positive @entity1 were administered @entity7015 , @entity4581 and a proton pump inhibitor for 1 week. @entity1 with continuing @entity281 were then given a second 1-week course of @entity115 , @entity4581 and @entity11450 . @entity1 still infected after the second course underwent upper @entity344 with @entity1534 culture, and then received a 1-week quadruple proton pump inhibitor- @entity1535 based scheme established on H. @entity1534 antibiotic sensitivity. RESULTS: After the first step, eradication was achieved in 2063 out of 2413 @entity1 [86% per protocol analysis (PP); 79% intention-to-treat analysis (ITT)]. First-step failures (350 out of 2413; 14.5% PP) showed second-step eradication rates of 82% (271 out of 329 @entity1 , PP; 77% ITT). The specific quadruple therapy for second-step failures (58 out of 329, 18% PP) achieved 77% (30 out of 39 @entity1 , PP) or 52% (ITT) success. This algorithm led to overall eradication rates of 99% (PP) or 91% (ITT). CONCLUSIONS: This multi-step strategy succeeded in a high percentage of @entity1534 infected @entity1 . Given the lack of precise guidelines on treatment failures, assessing @entity1534 sensitivity to antibiotics only after failure of the second treatment could be suggested in clinical practice.
