The Efficacy And Cost-effectiveness Analysis Of The Rescue Therapy For Treament Failure Of Helicobacter Pylori Infection

Objective The patients that first-line treatment failure were treated with two kind of sequential therapy,and then we compare the efficacy of eradication of Helicobacter pylori. The aim of this study is to find an efficient,safe and economical rescue therapy.Methods One hundred chronic gastritis patients who have failed eradication after 7d therapy were randomly divided into two groups, trial group(n=54)who received sequential regimen,Rabcprazole 10mg,Potassium citratc 240mg and amoxicillin 1.0g for the first 5 days, and followed Rabeprazole 10 mg, Potassium citrate 240mg and moxifloxacin 400 mg, for the last 5 days; and control group(n=46)who received Rabeprazole 10 mg plus amoxicillin 1.Og for the first 5 days, and followed Rabeprazole 10 mg, clarithromycin 500 mg and metronidazole 400mg, for the last 5 days. Amoxicillin and clarithromycin were given onece daily,other drugs were given twice daily. After finishing of H. pylori therapy at least four weeks later, we compared the H. pylori status, clinical symptoms and side-effects among two groups by inquisition, endoscopy and 13C-urea breath test(13C-UBT). Using pearson X2 tests analysis the differences in efficacy between the two treatment methods.And the two regiments were evaluated by Cost-benefit analysis.Results 1. The eradication rate of the trial group was significantly higher than that of the control group in the intention-to-treat analysis(85.19% VS 65.21%; 0.01<P<0.05; difference), and the per-protocol analysis(90.20% VS 66.67%; P<0.01; difference).2. The incidence of adverse reactions was not different significantly between the two groups (P>0.05).3. The costs of trial group and control group were RMB 265.32 and RMB199.74. But the cost-effectiveness rations of two groups were RMB 294.15 and RMB 299.60.Conclusion 1. After the first-line treatment failure, H. pylori eradication rate of the trial group was in the intention-to-treat analysis 85.19%,and the per-protocol analysis 90.20%.2. The cost-effectiveness rations of trial group is slightly lower than control group,so the sequential therapy is worthy of clinical.