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Third-line and rescue therapy for refractory Helicobacter pylori infection: A systematic review

World Journal of Gastroenterology 2023年第2期29卷 390-409页

作者： Pedro Vieira de Moraes Andrade Yan Mosca Monteiro ethel zimberg chehter Department of Gastroenterology Faculdade de Medicina do ABCSanto André09060-650SPBrazil

BACKGROUND Due to increasing resistance rates of Helicobacter pylori(***)to different antibiotics,failures in eradication therapies are becoming more *** though eradication criteria and treatment algorithms for first-line and second-line therapy against *** infection are well-established,there is no clear recommendation for third-line and rescue therapy in refractory *** *** To perform a systematic review evaluating the efficacy and safety of rescue therapies against refractory *** *** A systematic search of available rescue treatments for refractory *** infection was conducted on the National Library of Medicine’s PubMed search platform based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses *** or non-randomized clinical trials and observational studies evaluating the effectiveness of *** infection rescue therapies were *** Twenty-eight studies were included in the analysis of mean eradication rates as rescue therapy,and 21 of these were selected for analysis of mean eradication rate as third-line *** rifabutin-,sitafloxacin-,levofloxacin-,or metronidazole-based triple-therapy as third-line treatment,mean eradication rates of 81.6%and 84.4%,79.4%and 81.5%,55.7%and 60.6%,and 62.0%and 63.0%were found in intention-to-treat(ITT)and per-protocol(PP)analysis,*** third-line quadruple therapy,mean eradication rates of 69.2%and 72.1%were found for bismuth quadruple therapy(BQT),88.9%and 90.9%for bismuth quadruple therapy,three-in-one,Pylera®(BQT-Pylera),and 61.3%and 64.2%for non-BQT)in ITT and PP analysis,*** rifabutin-,sitafloxacin-,levofloxacin-,or metronidazole-based triple therapy as rescue therapy,mean eradication rates of 75.4%and 78.8%,79.4 and 81.5%,55.7%and 60.6%,and 62.0%and 63.0%were found in ITT and PP analysis,*** quadruple therapy as rescue treatment,mean eradication rates of 76.7%and 79.2%for BQT,

关键词： Helicobacter pylori Refractory infection Third-line therapy Rescue therapy Eradication Treatment

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