The impact of primary antibiotic resistance on the efficacy of @entity5616 bismuth @entity1792 - vs. @entity4546 -based one-week triple therapies in XXXX eradication--a randomised controlled trial.

@entity1 @entity868 @entity115 @entity1792 @entity4581 @entity344 @entity1534 @entity2210 @entity5616 @entity11450 @entity4546
AIMS: To compare @entity11450 with @entity4546 as to their efficacy to eradicate @entity1534 in two different treatment schedules both consisting of a combination of either of above with two antibiotics for 1 week, and to relate these treatment results to primary antibiotic resistance. METHODS: 256 @entity1534 positive @entity1 with non-ulcer @entity2210 were randomised to one of the following four treatment groups: @entity4546 20 mg + @entity4581 500 mg + @entity115 1000 mg (OCA); @entity5616 bismuth @entity1792 400 mg + @entity4581 500 mg + @entity115 1000 mg (RBCCA); @entity4546 20 mg + @entity4581 500 mg + @entity868 500 mg (OCM); @entity5616 bismuth @entity1792 400 mg + @entity4581 500 mg + @entity868 500 mg (RBCCM). All drugs were given twice daily for one week. The @entity1 were assessed for prevalence of @entity1534 by CLO test, histology and culture on gastric biopsy samples obtained during upper @entity344 before randomisation and 4-6 weeks after completion of therapy. Bacterial sensitivity to @entity4581 , @entity868 and @entity115 was determined by E-test. RESULTS: On per-protocol analysis, overall eradication rates were 96% for RBCCA vs. 85% for OCA (p = 0.03), and 95% for RBCCM vs. 79% for OCM (p = 0.01). Amongst the 196 @entity1 (77% of the entire study group) in whom antibiotic sensitivity testing was technically feasible, primary resistance was found in 8% for @entity4581 , in 33% for @entity868 , and in 0% for @entity115 . Eradication of @entity4581 sensitive/resistant strains was 89%/40% for OCA (p = 0.0042) and 98%/80% for RBCCA (p = 0.0428). When strains were sensitive to both antibiotics, cure rates with OCM/RBCCM were 87%/96% respectively (p = 0.39), for strains resistant to @entity4581 only, eradication was achieved in 82% with OCM vs. 94% with RBCCM (p = 0.2), and in the case of @entity868 resistance in 85% with OCM vs. 94% with RBCCM (p = 0.09). CONCLUSIONS: @entity11450 in combination with @entity4581 and either @entity868 or @entity115 produced higher eradication rates than @entity4546 co-administered with the same antibiotics. This appeared especially prominent in the subgroups with @entity4581 resistance without, however, reaching statistical significance. Efficacy of neither eradication regimen was influenced by @entity868 sensitivity to a significant degree.
