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Application of minocycline in patients with Helicobacter pylori infection allergic to penicillin

Abstract

To observe the eradication rate, safety and compliance of bismuth quadruple therapies based on minocycline in the newly diagnosed patients with Helicobacter pylori (Hp) infection. We selected 150 penicillin allergic patients for the initial treatment of Hp infection treated in Beijing Jishuitan hospital from January 2018 to February 2019. Subsequently, the patients were randomly selected into the minocycline and metronidazole-containing group (RMMB) and minocycline and levofloxacin-containing group (RMLB). The total course of treatment is 14 days. Follow-up clinical manifestations 3 to 5 days after treatment. The 13C urea breath test was performed 4 to 12 weeks to confirm the eradication of Hp. There were no significant differences in baseline data between the two groups (p>0.05). According to ITT analysis, the eradication rates of RMMB group and RMLB group were 80.3% (61/76) and 89.2% (66/74), respectively (χ2=2.301, p=0.129). According to PP analysis, the eradication rates of the RMMB group and the RMLB group were 83.6% (61/73) and 90.4% (66/73), respectively (χ2=1.513, p=0.21). The overall incidences of adverse events were 47.4% and 38.8% in the RMMB and RMLB groups, respectively (p=0.924). In patients with penicillin allergy, the eradication rate of minocycline-based bismuth quadruple therapies is ideal and the side effects are few. It is recommended for the eradication treatment of Hp-infected patients with penicillin allergy.

Keywords:
Helicobacter pylori; minocycline; bismuth quadruple protocol; penicillin allergy; levofloxacin; metronidazole

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