- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03571230
Antimicrobial Susceptibility Testing Guided Therapy Versus Empirical Therapy for the First-line Helicobacter Pylori Eradication.
10-Day Antimicrobial Susceptibility Testing Guided Triple Therapy Versus 14-Day Empirical Tailored Therapy for the First-line Treatment of Helicobacter Pylori Infection-A Randomized Controlled Trail
Study Overview
Status
Intervention / Treatment
- Drug: two sensitive antibiotics(amoxicillin, clarithromycin, metronidazole, tinidazole, levofloxacin, furazolidone and tetracycline)
- Drug: one proton pump inhibitor(PPI)
- Drug: two antibiotics based on personal medication history(amoxicillin,clarithromycin,furazolidone)
- Drug: Colloidal Bismuth Pectin
- Drug: two antibiotics for failed eradication(tetracyclin,furazolidone)
Detailed Description
Helicobacter pylori(H.pylori), which infects about 50% of the global population, has been recognized as a main risk factor of multiple gastric pathologies, especially non-cardiac gastric cancer. Strongly evidence supports that H.pylori eradication is an effective approach to reduce the incidence of those pathologies. Antimicrobial susceptibility test can pick out sensitive drugs to kill Helicobacter pylori, and reduce secondary drug resistance. But, there is a lack of high quality RCT to compare its efficacy with empirical regimen in the first-line treatment.
Our study aims to assess the efficacy of 10-day antimicrobial susceptibility test guided triple therapy for the first-line treatment of Helicobacter pylori infection. Comparing this regimen with 14-day Empirical Tailored Therapy to tell which one is better in clinic practice. We also want to find whether the 10-day antimicrobial susceptibility test guided triple therapy has less intestinal dysbacteriosis with a shorter duration.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Xiuli Zuo, PhD,MD
- Phone Number: 053188369277 15588818685
- Email: zuoxiuli@sina.com
Study Locations
-
-
Shandong
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Jinan, Shandong, China
- Xiuli Zuo
-
Contact:
- Xiuli Zuo, PhD,MD
- Phone Number: 053188369277 15588818685
- Email: zuoxiuli@sina.com
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients aged 18-70 with H. pylori infection.
Exclusion Criteria:
- Patients with previous H. pylori eradication therapy;
- Patients unable or unwilling to receive gastroscopy;
- Patients treated with H2-receptor antagonist, PPI, bismuth and antibiotics in the previous 4 weeks;
- Patients with gastrectomy, acute GI bleeding and advanced gastric cancer;
- Patients with known or suspected allergy to study medications;
- Currently pregnant or lactating;
- Inability to provide informed consent and other situations that could interfere with the examination or therapeutic protocol.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Antimicrobial susceptibility testing guided therapy
Patients in this group will receive a 10-day triple therapy for the Helicobacter pylori eradication. The regimen contains one proton pump inhibitor and two sensitive antibiotics determined by AST. The susceptibility of amoxicillin, clarithromycin, metronidazole, tinidazole, levofloxacin, furazolidone and tetracycline will be evaluated. Drugs: 1.one proton pump inhibitor: lansoprazole 30mg bid for 10d 2.two sensitive antibiotics: amoxicillin 1000mg bid for 10d, clarithromycin 500mg bid for 10d, metronidazole 500mg tid for 10d, tinidazole 500mg tid for 10d, levofloxacin 500mg qd for 10d, furazolidone 100mg bid for 10d, tetracycline 750mg bid for 10d. |
Patients will receive a 10-day triple therapy for the H.pylori eradication.
The regimen contains one PPI and two sensitive antibiotics determined by AST.
The susceptibility of amoxicillin, clarithromycin, metronidazole, tinidazole, levofloxacin, furazolidone and tetracycline will be evaluated.
All the patients need this drug.
|
Experimental: Empirical tailored therapy
Patients in this group will receive a 14-day bismuth-based quadruple therapy for the H.pylori eradication. The regimen contains one PPI, Colloidal Bismuth Pectin and two antibiotics based on personal medication history. If the patient has taken clarithromycin, roxithromycin and azithromycin for less than 2 weeks before, he will be treated with amoxicillin and clarithromycin. Otherwise, he will be treated with amoxicillin and furazolidone. Drugs: 1.one proton pump inhibitor: lansoprazole 30mg bid for 14d 2.Colloidal Bismuth Pectin 200mg bid for 14d 3.two antibiotics based on personal medication history: amoxicillin 1000mg bid and clarithromycin 500mg bid for 14d, amoxicillin 1000mg bid and furazolidone 100mg bid for 14d. |
All the patients need this drug.
Patients will receive a 14-day bismuth-based quadruple therapy for the H.pylori eradication.
The regimen contains one PPI, Colloidal Bismuth Pectin and two antibiotics based on personal medication history.
If the patient has taken clarithromycin, roxithromycin and azithromycin for less than 2 weeks before, he will be treated with amoxicillin and clarithromycin.
Otherwise, he will be treated with amoxicillin and furazolidone.
All the patients treated with 14-day bismuth-based quadruple therapy need this drug.
|
Other: Salvage therapy for negative culture
When the culture results are negative, patients will receive 14-day empirical tailored therapy based on personal medication history. Drugs: 1.one proton pump inhibitor: lansoprazole 30mg bid for 14d 2.Colloidal Bismuth Pectin 200mg bid for 14d 3.two antibiotics based on personal medication history: amoxicillin 1000mg bid and clarithromycin 500mg bid for 14d, amoxicillin 1000mg bid and furazolidone 100mg bid for 14d. |
All the patients need this drug.
Patients will receive a 14-day bismuth-based quadruple therapy for the H.pylori eradication.
The regimen contains one PPI, Colloidal Bismuth Pectin and two antibiotics based on personal medication history.
If the patient has taken clarithromycin, roxithromycin and azithromycin for less than 2 weeks before, he will be treated with amoxicillin and clarithromycin.
Otherwise, he will be treated with amoxicillin and furazolidone.
All the patients treated with 14-day bismuth-based quadruple therapy need this drug.
|
Other: Salvage therapy for failed eradication
If patients failed with AST guided eradication therapy or empirical therapy, patients will be treated with another 14-day bismuth-based quadruple therapy. Drugs: 1.one proton pump inhibitor: lansoprazole 30mg bid for 14d 2.Colloidal Bismuth Pectin 200mg bid for 14d 3.two antibiotics for rescue therapy: tetracycline 750mg bid and furazolidone 100mg bid for 14d. |
All the patients need this drug.
All the patients treated with 14-day bismuth-based quadruple therapy need this drug.
If the patients failed with AST guided eradication therapy or empirical therapy, patients will be treated with another 14-day bismuth-based quadruple therapy.
The regimen contains one PPI, Colloidal Bismuth Pectin, tetracycline and furazolidone.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Eradication rates in 2 groups
Time Frame: 6 months
|
Both intention to treat(ITT) and per-protocol(PP) analyses will be used for the assessment of the eradication rates of Helicobacter pylori infections in two groups.
The ITT analysis includes all randomly assigned patients who take at least one dose of the study medications.
The PP analysis is limited to patients who take over 90% of the study medications and complete follow-up.
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The rate of good compliance
Time Frame: 6 months
|
Patients taken over 90% of drugs are considered to have a good compliance.
|
6 months
|
The rate of improving dyspepsia symptoms after Helicobacter pylori eradication.
Time Frame: 6 months
|
Dyspepsia symptoms will be measured using a 8-point Likert scale, and patients rate their symptoms from 0 (none) to 8 (severe) before and after the Helicobacter pylori eradication.
|
6 months
|
The rate of adverse events happening
Time Frame: 6 months
|
Similarly, adverse events will also be measured by the Likert scale.
|
6 months
|
Difference of cost per patient for each eradication achieved in two groups
Time Frame: 6 months
|
6 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Xiuli Zuo, PhD,MD, Qilu Hospital of Shandong University
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Disease Attributes
- Gram-Negative Bacterial Infections
- Bacterial Infections
- Bacterial Infections and Mycoses
- Infections
- Disease Susceptibility
- Helicobacter Infections
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents, Local
- Anti-Infective Agents
- Enzyme Inhibitors
- Antineoplastic Agents
- Gastrointestinal Agents
- Alkylating Agents
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Cytochrome P-450 CYP3A Inhibitors
- Cytochrome P-450 Enzyme Inhibitors
- Protein Synthesis Inhibitors
- Antiprotozoal Agents
- Antiparasitic Agents
- Monoamine Oxidase Inhibitors
- Antitubercular Agents
- Cytochrome P-450 CYP1A2 Inhibitors
- Antacids
- Anti-Infective Agents, Urinary
- Renal Agents
- Antitrichomonal Agents
- Metronidazole
- Anti-Bacterial Agents
- Antibiotics, Antitubercular
- Amoxicillin
- Clarithromycin
- Levofloxacin
- Tinidazole
- Bismuth
- Tetracycline
- Proton Pump Inhibitors
- Furazolidone
Other Study ID Numbers
- 2017SDU-QILU-G003
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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