tetracycline and Lymphoma--Non-Hodgkin

We investigated to compare the effect of empirical therapy vs clarithromycin resistance-guided tailored therapy (tailored therapy) for eradication of Helicobacter pylori.. In this prospective, single center, open-label randomized controlled trial, we enrolled 72 patients with H. pylori infection from January 2019 through June 2019 in Korea. The patients were randomly assigned to both groups received empirical (n = 36) or tailored therapy (n = 36). Empirical therapy was defined as triple therapy with esomeprazole, amoxicillin, and clarithromycin for 10 days irrespective of clarithromycin resistance. Tailored therapy was triple or quadruple therapy with esomeprazole, metronidazole, tetracycline, and bismuth for 10 days based on genotype markers of resistance determined by gastric biopsy. Resistance-associated mutations in 23S rRNA were confirmed by multiplex polymerase chain reaction. Eradication status was assessed by C-urea breath test, and the primary outcome was eradication rates.. H. pylori was eradicated in 27 patients (75.0%), given empirical therapy and 32 patients (88.9%) treated with tailored therapy (P = 0.136) in intention-to-treat analysis. In per protocol analysis, the eradication rate was 97.0% and 81.8% in tailoredvs empirical groups (P = 0.046). Although clarithromycin-resistant H. pylori was eradicated in 3/9 (33.3%) with empirical therapy, it was treated in 11/12 (91.7%) with tailored therapy (P = 0.009). There was no difference in compliance between 2 groups. The rate of adverse events of the tailored group was higher than that of the empirical group (P = 0.036) because quadruple therapy had more side effects than those of triple therapy (P = 0.001).. Tailored therapy based on polymerase chain reaction is a good alternative to increase eradication rates in a region of high prevalence of clarithromycin resistance (see Visual Abstract, Supplementary Digital Content 1, http://links.lww.com/CTG/A342).

Topics: Aged; Amoxicillin; Anti-Bacterial Agents; Biopsy; Bismuth; Clarithromycin; DNA, Bacterial; Drug Resistance, Bacterial; Drug Therapy, Combination; Esomeprazole; Female; Gastric Mucosa; Helicobacter Infections; Helicobacter pylori; Humans; Lymphoma, Non-Hodgkin; Male; Metronidazole; Middle Aged; Polymerase Chain Reaction; Prospective Studies; Republic of Korea; RNA, Ribosomal, 23S; Stomach Neoplasms; Tetracycline; Treatment Outcome

Topics: Autopsy; Biopsy; Celiac Disease; Chlorambucil; Gastrointestinal Neoplasms; Humans; Intestinal Polyps; Israel; Leukemia, Lymphoid; Lymphoma, Non-Hodgkin; Male; Middle Aged; Prednisone; Tetracycline

Topics: Adult; Ampicillin; Bacteriuria; Chloramphenicol; Humans; Kidney Diseases; Lymphoma, Non-Hodgkin; Male; Salmonella Infections; Salmonella typhimurium; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Culture Techniques; Dimethyl Sulfoxide; Erythromycin; Lincomycin; Lymphoma, Non-Hodgkin; Mycoplasma; Mycoplasma Infections; Neoplasm Transplantation; Rats; Sarcoma, Experimental; Temperature; Tetracycline

Topics: Aged; Agranulocytosis; Anti-Bacterial Agents; Bacteroides; Brucella; Chloramphenicol; Complement System Proteins; Endotoxins; Erythromycin; Hodgkin Disease; Humans; Leukemia; Leukopenia; Lymphadenitis; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Multiple Myeloma; Neoplasms; Penicillins; Primary Myelofibrosis; Properdin; Research; Sarcoma; Streptomycin; Tetracycline

Topics: Absorption; Anilides; Antineoplastic Agents; Biomedical Research; Blood; Dogs; Kidney Diseases; Kidney Neoplasms; Kidney Tubules; Lymphoma; Lymphoma, Non-Hodgkin; Metabolic Diseases; Metabolism; Tetracycline; Toxicology; Urine

Topics: Achlorhydria; Ascites; Bile; Biomedical Research; Body Fluids; Duodenal Ulcer; Fluorescence; Gastric Lavage; Hernia, Diaphragmatic; Humans; Leiomyosarcoma; Lymphoma; Lymphoma, Non-Hodgkin; Neoplasms; Pancreatic Juice; Pleural Effusion; Polyps; Secretin; Stomach; Stomach Neoplasms; Stomach Ulcer; Tetracycline

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Antibiotics, Antitubercular; Belgium; Celiac Disease; Chloramphenicol; Dermatologic Agents; Geriatrics; Humans; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Peptic Ulcer Perforation; Sarcoma; Sprue, Tropical; Steatorrhea; Tetracycline