https://scholars.lib.ntu.edu.tw/handle/123456789/551383
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.author | Liou, Jyh-Ming | en_US |
dc.contributor.author | Chen, Po-Yueh | en_US |
dc.contributor.author | Luo, Jiing-Chyuan | en_US |
dc.contributor.author | Lee, Ji-Yuh | en_US |
dc.contributor.author | CHIEH-CHANG CHEN | en_US |
dc.contributor.author | YU-JEN FANG | en_US |
dc.contributor.author | Yang, Tsung-Hua | en_US |
dc.contributor.author | Chang, Chi-Yang | en_US |
dc.contributor.author | Bair, Ming-Jong | en_US |
dc.contributor.author | MEI-JYH CHEN | en_US |
dc.contributor.author | Hsu, Yao-Chun | en_US |
dc.contributor.author | WEN-FENG HSU | en_US |
dc.contributor.author | Chang, Chun-Chao | en_US |
dc.contributor.author | JAW-TOWN LIN | en_US |
dc.contributor.author | CHIA-TUNG SHUN | en_US |
dc.contributor.author | El-Omar, Emad M. | en_US |
dc.contributor.author | MING-SHIANG WU | en_US |
dc.contributor.author | Liou, Jyh-Ming | en_US |
dc.contributor.author | YI-CHIA LEE | en_US |
dc.contributor.author | Lin, Jaw-Town | en_US |
dc.contributor.author | Wu, Chun-Ying | en_US |
dc.contributor.author | Wu, Jeng-Yih | en_US |
dc.contributor.author | Lin, Chun-Hung | en_US |
dc.contributor.author | Fang, Yu-Ren | en_US |
dc.contributor.author | Luo, Jiing-Chyuan | en_US |
dc.contributor.author | TSU-YAO CHENG | en_US |
dc.contributor.author | PING-HUEI TSENG | en_US |
dc.contributor.author | HAN-MO CHIU | en_US |
dc.contributor.author | Chang, Chun-Chao | en_US |
dc.contributor.author | Yu, Chien-Chun | en_US |
dc.contributor.author | Chiu, Min-Chin | en_US |
dc.contributor.author | YEN-NIEN CHEN | en_US |
dc.contributor.author | Hu, Wen-Hao | en_US |
dc.contributor.author | Chou, Chu-Kuang | en_US |
dc.contributor.author | Tai, Chi-Ming | en_US |
dc.contributor.author | Lee, Ching-Tai | en_US |
dc.contributor.author | Wang, Wen-Lun | en_US |
dc.contributor.author | Chang, Wen-Shiung | en_US |
dc.contributor.author | Taiwan Gastrointestinal Disease and Helicobacter Consortium | en_US |
dc.contributor.author | Helicobacter Consortium | en_US |
dc.creator | Liou J.-M.;Chen P.-Y.;Luo J.-C.;Lee J.-Y.;Chen C.-C.;Fang Y.-J.;Yang T.-H.;Chang C.-Y.;Bair M.-J.;Chen M.-J.;Hsu Y.-C.;Hsu W.-F.;Chang C.-C.;Lin J.-T.;Shun C.-T.;El-Omar E.M.;Wu M.-S.;Liou J.-M.;Lee Y.-C.;Lin J.-T.;Wu C.-Y.;Wu J.-Y.;Chen C.-C.;Lin C.-H.;Fang Y.-R.;Bair M.-J.;Luo J.-C.;Tsu-Yao Cheng;Tseng P.-H.;Chiu H.-M.;Chang C.-C.;Yu C.-C.;Chiu M.-C.;Chen Y.-N.;Hu W.-H.;Chou C.-K.;Tai C.-M.;Lee C.-T.;Wang W.-L.;Chang W.-S.;Taiwan Gastrointestinal Disease;Helicobacter Consortium | - |
dc.date.accessioned | 2021-03-10T07:09:08Z | - |
dc.date.available | 2021-03-10T07:09:08Z | - |
dc.date.issued | 2018-10 | - |
dc.identifier.issn | 0016-5085 | - |
dc.identifier.uri | https://scholars.lib.ntu.edu.tw/handle/123456789/551383 | - |
dc.identifier.uri | https://www.scopus.com/record/display.uri?eid=2-s2.0-85054164338&doi=10.1053%2fj.gastro.2018.06.047&origin=inward&txGid=0fa7ecffa4afc72946125fc01d30b9c7 | - |
dc.description.abstract | Background & Aims: We aimed to compare the efficacy of genotypic resistance–guided therapy vs empirical therapy for eradication of refractory Helicobacter pylori infection in randomized controlled trials. Methods: We performed 2 multicenter, open-label trials of patients with H pylori infection (20 years or older) failed by 2 or more previous treatment regimens, from October 2012 through September 2017 in Taiwan. The patients were randomly assigned to groups given genotypic resistance–guided therapy for 14 days (n = 21 in trial 1, n = 205 in trial 2) or empirical therapy according to medication history for 14 days (n = 20 in trial 1, n = 205 in trial 2). Patients received sequential therapy containing esomeprazole and amoxicillin for the first 7 days, followed by esomeprazole and metronidazole, with levofloxacin, clarithromycin, or tetracycline (doxycycline in trial 1, tetracycline in trial 2) for another 7 days (all given twice daily) based on genotype markers of resistance determined from gastric biopsy specimens (group A) or empirical therapy according to medication history. Resistance-associated mutations in 23S ribosomal RNA or gyrase A were identified by polymerase chain reaction with direct sequencing. Eradication status was determined by 13C-urea breath test. The primary outcome was eradication rate. Results: H pylori infection was eradicated in 17 of 21 (81%) patients receiving genotype resistance–guided therapy and 12 of 20 (60%) patients receiving empirical therapy (P =.181) in trial 1. This trial was terminated ahead of schedule due to the low rate of eradication in patients given doxycycline sequential therapy (15 of 26 [57.7%]). In trial 2, H pylori infection was eradicated in 160 of 205 (78%) patients receiving genotype resistance–guided therapy and 148 of 205 (72.2%) patients receiving empirical therapy (P =.170), according to intent to treat analysis. The frequencies of adverse effects and compliance did not differ significantly between groups. Conclusions: Properly designed empirical therapy, based on medication history, is an acceptable alternative to genotypic resistance–guided therapy for eradication of refractory H pylori infection after consideration of accessibility, cost, and patient preference. ClinicalTrials.gov ID: NCT01725906. ? 2018 AGA Institute | en_US |
dc.relation.ispartof | Gastroenterology | en_US |
dc.subject.classification | [SDGs]SDG3 | - |
dc.subject.other | amoxicillin; clarithromycin; DNA topoisomerase (ATP hydrolysing) A; doxycycline; esomeprazole; levofloxacin; metronidazole; RNA 23S; tetracycline; urea c 13; amoxicillin; antiinfective agent; clarithromycin; doxycycline; esomeprazole; levofloxacin; metronidazole; proton pump inhibitor; tetracycline; abdominal pain; adult; antibiotic resistance; Article; bloating; breath analysis; comparative effectiveness; constipation; controlled study; diarrhea; dizziness; empirical therapy; eradication therapy; female; gene mutation; genotype; headache; Helicobacter infection; human; human tissue; intention to treat analysis; intermethod comparison; major clinical study; male; marker gene; multicenter study; nausea; patient compliance; polymerase chain reaction; priority journal; randomized controlled trial; rash; resistance guided therapy; sequence analysis; single blind procedure; stomach biopsy; Taiwan; taste disorder; treatment failure; treatment outcome; vomiting; aged; clinical decision making; clinical trial; combination drug therapy; comparative study; drug administration; drug effect; genetics; Helicobacter infection; Helicobacter pylori; microbiological examination; microbiology; middle aged; pathogenicity; predictive value; time factor; Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Bacteriological Techniques; Breath Tests; Clarithromycin; Clinical Decision-Making; Doxycycline; Drug Administration Schedule; Drug Resistance, Bacterial; Drug Therapy, Combination; Esomeprazole; Female; Genotype; Helicobacter Infections; Helicobacter pylori; Humans; Levofloxacin; Male; Metronidazole; Middle Aged; Predictive Value of Tests; Proton Pump Inhibitors; Taiwan; Tetracycline; Time Factors; Treatment Outcome | - |
dc.title | Efficacies of Genotypic Resistance-Guided vs Empirical Therapy for Refractory Helicobacter pylori Infection | en_US |
dc.type | journal article | en |
dc.identifier.doi | 10.1053/j.gastro.2018.06.047 | - |
dc.identifier.pmid | 29964036 | - |
dc.identifier.scopus | 2-s2.0-85054164338 | - |
dc.relation.pages | 1109 | en_US |
dc.relation.journalvolume | 155 | en_US |
dc.relation.journalissue | 4 | en_US |
dc.relation.pageend | 1119 | en_US |
item.fulltext | no fulltext | - |
item.grantfulltext | none | - |
item.openairetype | journal article | - |
item.openairecristype | http://purl.org/coar/resource_type/c_6501 | - |
item.cerifentitytype | Publications | - |
crisitem.author.dept | Internal Medicine | - |
crisitem.author.dept | Internal Medicine-NTUH | - |
crisitem.author.dept | Internal Medicine | - |
crisitem.author.dept | Internal Medicine-NTUHYL | - |
crisitem.author.dept | Internal Medicine | - |
crisitem.author.dept | Internal Medicine-NTUH | - |
crisitem.author.dept | Internal Medicine | - |
crisitem.author.dept | Internal Medicine-NTUH | - |
crisitem.author.dept | Internal Medicine-NTUH | - |
crisitem.author.dept | Forensic Medicine | - |
crisitem.author.dept | Internal Medicine | - |
crisitem.author.dept | Internal Medicine-NTUH | - |
crisitem.author.dept | Internal Medicine-NTUH | - |
crisitem.author.dept | Laboratory Medicine | - |
crisitem.author.dept | Laboratory Medicine-NTUH | - |
crisitem.author.dept | Internal Medicine | - |
crisitem.author.dept | Internal Medicine-NTUH | - |
crisitem.author.dept | Integrated Diagnostics and Therapeutics-NTUH | - |
crisitem.author.dept | Medicine-NTUCC | - |
crisitem.author.orcid | 0000-0003-2953-210X | - |
crisitem.author.orcid | 0000-0003-3284-004X | - |
crisitem.author.orcid | 0000-0001-7138-2614 | - |
crisitem.author.orcid | 0000-0002-0468-4468 | - |
crisitem.author.orcid | 0000-0002-1940-6428 | - |
crisitem.author.orcid | 0000-0002-8160-1216 | - |
crisitem.author.orcid | 0000-0002-7370-5605 | - |
crisitem.author.orcid | 0000-0002-7483-7538 | - |
crisitem.author.orcid | 0000-0003-2786-8056 | - |
crisitem.author.parentorg | College of Medicine | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | College of Medicine | - |
crisitem.author.parentorg | National Taiwan University Hospital Yun-Lin Branch | - |
crisitem.author.parentorg | College of Medicine | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | College of Medicine | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | College of Medicine | - |
crisitem.author.parentorg | College of Medicine | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | College of Medicine | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | College of Medicine | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | National Taiwan University Cancer Center (NTUCC) | - |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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