Efficacies of Susceptibility-guided vs Empiric Therapy for Rescue Treatment of Helicobacter Pylori Infection
Helicobacter Pylori Infection
About this trial
This is an interventional treatment trial for Helicobacter Pylori Infection focused on measuring Helicobacter pylori, antimicrobial susceptibility testing, minimal inhibitory concentration, susceptibility-guided tailored therapy, guideline-recommended empiric therapy
Eligibility Criteria
Inclusion Criteria:
Patients, aged >= 20, having H. pylori-positive chronic gastritis with/without peptic ulcers (duodenal or gastric ulcers) will be recruited. If the patients failed anti-H. pylori therapy previously, they will be invited to enter this study for evaluating the efficacy of these rescue regimens.
Exclusion Criteria:
- pregnant or nursing woman;
- serious concomitant illness and malignant tumor of any kind;
- history of hypersensitivity to test drugs;
- serious bleeding during the course of this ulcer;
- previous gastric surgery;
- receiving bismuth salts, PPIs, or antibiotics in the previous month.
Sites / Locations
- National Taiwan University HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
susceptibility-guided tailored therapy (Group A)
guidelines-recommended empiric therapy (Group B)
Includes 5 treatment options. The priority order of treatment regimens is based on the selection principal through AST with MIC profile. 1. clarithromycin triple therapy: include rabeprazole 20mg bid, amoxicillin 1 g bid, and clarithromycin 500 mg bid, for 14 days; or 2. levofloxacin triple therapy: include rapeprazole 20 mg bid, amoxicillin 1 g bid, and levofloxacin 500 mg bid, for 14 days; or 3. metronidazole triple therapy: include rabeprazole 20 mg bid, amoxicillin 500 mg qid, and metronidazole 250 mg qid, for 14 days; or 4. high-dose dual therapy: include rabeprazole 20 mg qid, amoxicillin 750 mg qid, for 14 days; or 5. bismuth quadruple therapy: include rabeprazole 20 mg bid, bismuth 120 mg qid, metronidazole 500 mg tid, and tetracycline 500 mg qid, for 14 days.
bismuth quadruple therapy: include rabeprazole 20 mg bid, bismuth 120 mg qid, metronidazole 500 mg tid, and tetracycline 500 mg qid, for 14 days.