In the day PBAT group, the most frequent adverse events were epigastric discomfort On univariate analysis, male sex OR, 0. The multivariate analysis confirmed that both male sex OR, 0. Antibiotic resistance is one of the main causes of treatment failure in H. The rates of clarithromycin resistance increased rapidly from In contrast, the rates of resistance to amoxicillin and tetracycline are relatively low, at We hypothesized that a quadruple regimen containing amoxicillin and tetracycline would demonstrate a superior eradication rate and could be a suitable substitute for triple or sequential regimens in the first-line treatment of H.
However, some controversies in the results and large heterogeneity in the duration or the first- or second-line regimen exists in previous studies of amoxicillin- and tetracycline-containing quadruple regimens. For instance, in a study of the day quadruple regimen, the eradication rate was In contrast, a Chinese study showed that the eradication rate of day LBAT lansoprazole, bismuth, amoxicillin, and tetracycline was Chi et al.
Since H. However, any possible antagonistic effect between these two antibiotics is unclear and it is difficult to elucidate because data on the gastric bioavailability of tetracycline is lacking [ 29 ]. Furthermore, several studies showed a good eradication rate Published in , the meta-analysis, which included 9 RCTs, showed that the total eradication rate of a quadruple regimen containing amoxicillin and tetracycline was In our study, we used different doses and intervals of PBAT compared with those of previous studies to maximize subject compliance.
In previous studies, bismuth was administered at mg and tetracycline at mg, both four times a day [ 21 , 31 ]. The mixture of twice a day and four times a day can influence drug compliance.
In the present clinical trial bismuth mg twice a day and tetracycline mg twice a day were chosen to increase compliance. Tetracycline is a time-dependent half-life 8—10 h antibiotic agent and has a long post-antibiotic effect PAE [ 33 ]. Even though a high blood concentration of tetracycline does not increase its sterilizing power, it can inhibit bacterial regrowth for a longer period of time [ 34 , 35 ]. From these pharmacokinetic considerations, a twice-a-day regimen is also appropriate and is likely to promote patient compliance.
The drug compliance in the present study was In addition, this rate is higher than the This clinical trial had some limitations. First, H. The first-line or second-line eradication rate of PBAT was More antibiotic susceptibility data are needed in a future study to confirm the eradication effect of amoxicillin and tetracycline-containing regimens both in vitro and in vivo.
Second, the limited accuracy of 13 C-UBT at 4—6 weeks after the completion of a bismuth-based treatment that makes possible, at least in part, a false negative diagnosis of H.
It is very difficult to perform invasive H. Third, we cannot elucidate the reason why PBAT showed a lower eradication rate than expected. However, there is a fairly large eradication rate gap between positive and negative studies. Further study is needed in the future. In conclusion, this prospective, multi-center, randomized, open-label, parallel design clinical trial demonstrated that SQT for 10 days appears more effective than PBAT in spite of frequent adverse events.
Thus, additional trials are necessary to identify a more satisfactory first-line eradication therapy for H. McColl KE. Clinical practice. Helicobacter pylori infection. New Engl J Med. A report card to grade Helicobacter pylori therapy. Article PubMed Google Scholar. Kyoto global consensus report on Helicobacter pylori gastritis.
Factors affecting first-line triple therapy of Helicobacter pylori including CYP2C19 genotype and antibiotic resistance. Dig Dis Sci. Graham DY, Fischbach L. Helicobacter pylori treatment in the era of increasing antibiotic resistance. Meta-analysis: sequential therapy appears superior to standard therapy for Helicobacter pylori infection in patients naive to treatment. Annals Intern Med. Article Google Scholar. Sequential therapy or triple therapy for Helicobacter pylori infection: systematic review and meta-analysis of randomized controlled trials in adults and children.
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Expert Rev. Anti Infect. Anses-ANMV, Google Scholar. Aperce, C. Effects of menthol supplementation in feedlot cattle diets on the fecal prevalence of antimicrobial-resistant Escherichia coli. PLoS One e Boireau, C. Antimicrobial resistance in bacteria isolated from mastitis in dairy cattle in France, — Dairy Sci. Antimicrobial resistance trends in Escherichia coli isolated from diseased food-producing animals in France: a year period time-series study.
Zoonoses Public Health 65, 86— Chen, X. Escherichia coli isolates from sick chickens in China: changes in antimicrobial resistance between and Cohen, A.
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Drug Resist. N 10, 65— The European Union summary report on antimicrobial resistance in zoonotic and indicator bacteria from humans, animals and food in Parma: EFSA. Sales of veterinary antimicrobial agents in 30 European countries in trends from to European Surveillance of Veterinary Antimicrobial Consumption.
Amsterdam: EMA. Ewers, C. Hanon, J. A trend analysis of antimicrobial resistance in commensal Escherichia coli from several livestock species in Belgium Karam, G.
Antibiotic strategies in the era of multidrug resistance. Care Lond. Magiorakos, A. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. R Core Team Vienna: R Foundation for Statistical Computing. The purpose of this study was to compare histologically the effectiveness of tetracycline and amoxicillin in limiting inflammatory root resorption IR secondary to pulpal infection, in replanted dogs' teeth.
Thirty root canals in five dogs were infected with plaque. The roots were extracted, the lingual mid-roots were shaved with a fissure bur ensuring cemental damage and immediately replanted.
Dogs were given either tetracycline hydrochloride or amoxicillin, administered orally, on the day of extraction and replantation and for the following 6 days.
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