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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Efficacy and safety of modified tetracycline dosing in a quadruple therapy for Helicobacter pylori: A retrospective single center study
Ying-Chao Sun, Meng-Jia Zhu, Xue-Qin Chen, Lei Yue, Yi-Ru Zhao, Xin-Jie Wang, John J Kim, Qin Du, Wei-Ling Hu
Ying-Chao Sun, Meng-Jia Zhu, Xue-Qin Chen, Lei Yue, Yi-Ru Zhao, Xin-Jie Wang, Wei-Ling Hu, Department of Gastroenterology, Sir Run Run Shaw Hospital, Medical School, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
John J Kim, Division of Gastroenterology, Loma Linda University Health, Loma Linda, CA 92354, United States
Qin Du, Department of Gastroenterology, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou 310009, Zhejiang Province, China
Wei-Ling Hu, Institute of Gastroenterology, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Author contributions: Yingchao Sun, Mengjia Zhu and Xueqin Chen have contributed equally to this work. Sun YC and Hu WL contributed to conceptualization; Sun YC and Wang XJ contributed to writing-original draft preparation; Zhu MJ and Yue L contributed to writing; Chen XQ, Zhao YR, and Zhu MJ contributed to review and editing; Kim JJ contributed to manuscript polishing; Hu WL contributed to supervision; and all authors have read and agreed to the published version of the manuscript.
Supported by the Zhejiang Provincial Natural Science Foundation, No. LY23H160016; and Zhejiang Medical Association, No. 2019ZYC-A88.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Sir Run Run Shaw Hospital, Medical School, Zhejiang University, Hangzhou (Approval No. SRRSH: 2022-431).
Informed consent statement: Patient consent was waived due the impossibility of identifying patients and the retrospective design of the investigation.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Wei-Ling Hu, MD, Doctor, Department of Gastroenterology, Sir Run Run Shaw Hospital, Medical School, Zhejiang University, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. huweiling@zju.edu.cn
Received: March 28, 2023
Peer-review started: March 28, 2023
First decision: April 26, 2023
Revised: May 9, 2023
Accepted: May 15, 2023
Article in press: May 15, 2023
Published online: June 14, 2023
BACKGROUND
Although highly effective as a component of Helicobacter pylori (H. pylori) treatment regimen, tetracycline is associated with a high incidence of medication-related adverse events. Modified dosing of tetracycline as part of quadruple therapy may improve safety while providing comparable eradication rates.
AIM
To evaluate the efficacy and safety of modified dosing of tetracycline in patients receiving tetracycline and furazolidone-containing quadruple therapy in patients with H. pylori infection.
METHODS
Consecutive patients (10/2020-12/2021) who received tetracycline and furazolidone quadruple therapy for H. pylori infection at Sir Run Run Shaw Hospital were identified. All patients received tetracycline, furazolidone, proton pump inhibitor, and bismuth for 14 d as primary or rescue therapy. Modified tetracycline dose group received tetracycline 500 mg twice daily while standard group received 750 mg twice daily or 500 mg three times daily.
RESULTS
Three hundred and ninety-four patients [mean age = 46.3 ± 13.9, male = 137 (34.8%), and 309 (78.4%) primary therapy] completed tetracycline and furazolidone quadruple therapy for H. pylori infection including those who received modified tetracycline dose in 157 and standard doses in 118 (750 mg twice daily) and 119 (500 mg three times daily). Eradication rates in the modified tetracycline dose group were 92.40% and in the standard groups, eradication rates were 93.20% for 750 mg twice daily group and 92.43% for 500 mg three times daily group, respectively, without statistical difference (P = 0.959). The incidence of adverse events was lower in the modified tetracycline dose (15.3% vs 32.3% and 29.4%; P = 0.002) compared to the standard dose group.
CONCLUSION
In a real-world experience, modified tetracycline dosing as part of tetracycline and furazolidone quadruple therapy for 14 d demonstrated high efficacy, comparable to standard tetracycline dose regimens, with a favorable safety profile.
Core Tip: To our knowledge, this is the first real-world study to evaluate the efficacy and safety of modified dosing of tetracycline as part of tetracycline and furazolidone-containing bismuth quadruple therapy in patients with Helicobacter pylori infection.
