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

Background The rising prevalence of antimicrobial resistance of Helicobacter pylori (HP)has caused the increasing failure of the first - line therapy.How to apply rescue therapy to this patients is difficult.The aim of this study is to find an efficient and safe rescue therapy.Objective To evaluate the efficacy and safety of 10 - days quadruple therapy with omeprazole,colloidal bismuth pectin,levofloxacin,and furazolidone as rescue therapy for the treatment failure of Helicobacter prlori(HP)infection.And compare the cost - effectiveness with the standard quadruple therapy of omeprazole,colloidal bismuth pectin,amoxicillin,and metronidazole.Methods sixty- seven patients who have failed eradication after ptoton pump inhibit(PPI)/bismuth- based triple/quadruple therapy or have relapsed after eradication were randomly divided into two groups.The treatment group(n = 35,M14,F21, age49.20)were administered Omeprazole(20 mg),Colloidal Bismuth pectin(200 mg), Levofloxacin(200 mg),Furazolidone(200 mg),twice a days,10 -days;The control group(n = 32,M10,F22,age48.59)were treated with Omeprazole(20 mg),Colloidal Bismuth pectin (200 mg),Amoxicillin(1000mg),Tinidazole(500mg),twice a day,10- days.Four weeks after completion of the therapy,the¹⁴C - urea breath test was performed to evaluate the success of HP eradication.Results One patient were lost to follow in both group.One patient in the treatment group stopped the treatment because of severe adverse drug reaction(ADR). On the intention to treat analysis and the perprotocol analysis,the eradication rates of HP in treatment group were 74.29%and 78.79%.the control group were 65.63%and 67.75%, the eradication rates of HP in treatment group is higher than that of the control group,but the difference was not significant by statistics(P＞0.05).The occurrence of ADR in the treatment group and control group were 18.75%and 16.12%,respectively with no significant difference.The respect- cost(C/E)of anti - HP therapy on each patient was 233.38 yuan(RMB)and 319.05 yuan(RMB)in the treatment group and control group.The expected cost of treatment group was 85.67 yuan(RMB)lower than that of the control group. Conelutions 10- day's therapy of Omeprazole,Colloidal Bismuth pectin,Levofloxacin and Furazolidone is an effective and safe rescue therapy.