scholarly journals High prevalence of clarithromycin resistance and effect on Helicobacter pylori eradication in a population from Santiago, Chile: cohort study and meta-analysis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
A. Arenas ◽  
C. Serrano ◽  
L. Quiñones ◽  
P. Harris ◽  
M. Sandoval ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Meta Analysis ◽  
Dual Therapy ◽  
Tertiary Hospital ◽  
High Dose ◽  
Rapid Urease Test ◽  
Clarithromycin Resistance ◽  
Pooled Prevalence ◽  
Urease Test ◽  
H Pylori

AbstractHelicobacter pylori (H. pylori) eradication using standard triple therapy (STT) with proton pump inhibitors (PPI), amoxicillin and clarithromycin (CLA) has been the standard in Latin America. However, CLA resistance is a rising problem affecting eradication rates. Genetic polymorphisms of CYP2C19, a PPI metabolizer may also affect eradication. The primary aims of this study were to evaluate the effect of clarithromycin resistance on H. pylori eradication in a population from Santiago, and to establish the pooled clarithromycin resistance in Santiago, Chile. Symptomatic adult patients attending a tertiary hospital in Santiago were recruited for this study. CLA resistance and the polymorphisms of CYP2C19 were determined on DNA extracted from gastric biopsies, using PCR. The STT was indicated for 14 days and eradication was determined by a urea breath test 4–6 weeks after therapy. A meta-analysis of CLA resistance studies among adult residents in Santiago was performed. Seventy-three out of 121 consecutive patients had positive rapid urease test (RUT) and received STT. Sixty-nine patients (95%) completed the study. The H. pylori eradication rate was 63% and the prevalence of CLA resistance was 26%. According to the CYP2C19 polymorphisms, 79.5% of the RUT-positive patients were extensive metabolizers. Multivariable analyses showed that only CLA resistance was significantly and inversely associated with failure of eradication (OR: 0.13; 95% confidence interval [95% CI], 0.04–0.49). A meta-analysis of two previous studies and our sample set (combined n = 194) yielded to a pooled prevalence of CLA resistance of 31.3% (95% CI 23.9–38.7). Our study shows that CLA resistance is associated with failure of H. pylori eradication. Given the high pooled prevalence of CLA resistance, consideration of CLA free therapies in Santiago is warranted. We could recommend bismuth quadruple therapy or high-dose dual therapy, according to bismuth availability. Further studies need to evaluate the best therapy.

scholarly journals Bismuth Containing Quadruple Therapy versus Tailored Therapy as first-line treatments for Helicobacter pylori infection in a high clarithromycin resistance area

2019 ◽  
Author(s):  
Byoung Wook Bang ◽  
Jong Beom Shin ◽  
Eun Jung Ko ◽  
Kye Sook Kwon ◽  
Yong Woon Shin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Cost Effective ◽  
Medical Costs ◽  
Rapid Urease Test ◽  
First Line ◽  
Tailored Therapy ◽  
Quadruple Therapy ◽  
Clarithromycin Resistance ◽  
Urease Test ◽  
H Pylori

Abstract Background Increasing clarithromycin resistance has led to the need for an alternative first-line therapy for the eradication of Helicobacter pylori (H. pylori) in Korea, and bismuth containing quadruple therapy (BQT) and tailored therapy (TT) have been proposed as alternative regimens. The aim of this study was to compare the eradication rates of BQT and TT as first-line H. pylori eradication therapies. Methods H. pylori infection was diagnosed using the rapid urease test or dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) during endoscopy. Patients positive for H. pylori were divided into two groups; those tested using the rapid urease test received empirical BQT (the BQT group) whereas those tested by DPO-PCR received TT (the TT group). Eradication rates, adverse events, and overall medical costs, which included diagnostic test and eradication regimen costs, were compared. Results Three hundred and sixty patients were included in the study (TT group 178, BQT group 182). The modified intention-to-treat eradication rates of BQT and TT were 88.2% (142/161) and 80.3% (118/147), respectively (p=0.055), and corresponding eradication rates in the per-protocol population were 88.8% (142/160) and 81.4% (118/145) (p=0.07). Compliance and adverse event rates were similar in the two groups. Average medical costs were $ 90.3 per patient in the TT group and $ 75.5 in the BQT group (p=0.000). Conclusions Empirical BQT and tailored therapy were similar in terms of H. pylori eradication rate, safety, and tolerability, but BQT was more cost-effective.

scholarly journals Bismuth Containing Quadruple Therapy versus Tailored Therapy as first-line treatments for Helicobacter pylori infection in a high clarithromycin resistance area

2019 ◽  
Author(s):  
Byoung Wook Bang ◽  
Jong Beom Shin ◽  
Eun Jung Ko ◽  
Kye Sook Kwon ◽  
Yong Woon Shin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Cost Effective ◽  
Medical Costs ◽  
Rapid Urease Test ◽  
First Line ◽  
Tailored Therapy ◽  
Quadruple Therapy ◽  
Clarithromycin Resistance ◽  
Urease Test ◽  
H Pylori

Abstract Background Increasing clarithromycin resistance has led to the need for an alternative first-line therapy for the eradication of Helicobacter pylori (H. pylori) in Korea, and bismuth containing quadruple therapy (BQT) and tailored therapy (TT) have been proposed as alternative regimens. The aim of this study was to compare the eradication rates of BQT and TT as first-line H. pylori eradication therapies. Methods H. pylori infection was diagnosed using the rapid urease test or dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) during endoscopy. Patients positive for H. pylori were divided into two groups; those tested using the rapid urease test received empirical BQT (the BQT group) whereas those tested by DPO-PCR received TT (the TT group). Eradication rates, adverse events, and overall medical costs, which included diagnostic test and eradication regimen costs, were compared. Results Three hundred and sixty patients were included in the study (TT group 178, BQT group 182). The modified intention-to-treat eradication rates of BQT and TT were 88.2% (142/161) and 80.3% (118/147), respectively (p=0.055), and corresponding eradication rates in the per-protocol population were 88.8% (142/160) and 81.4% (118/145) (p=0.07). Compliance and adverse event rates were similar in the two groups. Average medical costs were $ 90.3 per patient in the TT group and $ 75.5 in the BQT group (p=0.000). Conclusions Empirical BQT and tailored therapy were similar in terms of H. pylori eradication rate, safety, and tolerability, but BQT was more cost-effective.

scholarly journals High dose PPI-amoxicillin dual therapy for the treatment of Helicobacter pylori infection: a systematic review with meta-analysis

2020 ◽  
Vol 13 ◽  
pp. 175628482093711
Author(s):  
Yang-Jie Zhu ◽  
Yi Zhang ◽  
Ting-Yi Wang ◽  
Jing-Tao Zhao ◽  
Zhe Zhao ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Adverse Events ◽  
Eradication Rate ◽  
Meta Analysis ◽  
Dual Therapy ◽  
Controlled Trials ◽  
High Dose ◽  
First Line ◽  
Quadruple Therapy ◽  
H Pylori

Background: Helicobacter pylori resistance to amoxicillin remains rare in many regions. Proton pump inhibitor-amoxicillin-containing high dose dual therapy (HDDT) has been proposed to treat H. pylori infection. We aimed to assess the effectiveness and safety of PPI-amoxicillin HDDT for treatment of H. pylori infection in comparison with other regimens. Methods: Databases, including PubMed, Embase, and the Cochrane Register of Controlled Trials, were searched to find relevant publications. Randomized controlled trials comparing HDDT with control regimens for H. pylori eradication in adult patients were included. The primary outcome was eradication rate by intention-to-treat analysis. Adverse events were analyzed as second outcome. Results: A total of 15 trials with 3818 patients qualified for inclusion. The eradication rate of HDDT was neither significantly inferior nor superior to the recommended regimens such as triple therapy, bismuth quadruple therapy, and non-bismuth quadruple therapy [relative risk (RR): 1.00, 95% confidence interval (CI): 0.96–1.05, p = 0.870]. This finding was robust through subgroup analyses and sensitivity analyses. Trial sequential analysis showed that HDDT was equivalent to control regimens, and further similar trials were unlikely to alter the conclusions of this analysis. The frequency of adverse events was significantly lower in HDDT group (RR: 0.48, 95% CI: 0.37–0.64, p < 0.001). Conclusion: HDDT was equivalent to recommended first-line or rescue regimens with fewer adverse effects. The evidence from this meta-analysis supports the use of HDDT as first-line or rescue treatment for H. pylori infection. Trial registration: PROSPERO CRD42019133002

scholarly journals Bismuth Containing Quadruple Therapy versus Tailored Therapy as first-line treatments for Helicobacter pylori infection in a high clarithromycin resistance area

2019 ◽  
Author(s):  
Byoung Wook Bang ◽  
Jong Beom Shin ◽  
Eun Jung Ko ◽  
Kye Sook Kwon ◽  
Yong Woon Shin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Cost Effective ◽  
Medical Costs ◽  
Rapid Urease Test ◽  
First Line ◽  
Tailored Therapy ◽  
Quadruple Therapy ◽  
Clarithromycin Resistance ◽  
Urease Test ◽  
H Pylori

Abstract Background Increasing clarithromycin resistance has led to the need for an alternative first-line therapy for the eradication of Helicobacter pylori (H. pylori) in Korea, and bismuth containing quadruple therapy (BQT) and tailored therapy (TT) have been proposed as alternative regimens. The aim of this study was to compare the eradication rates of BQT and TT as first-line H. pylori eradication therapies. Methods H. pylori infection was diagnosed using the rapid urease test or dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) during endoscopy. Patients positive for H. pylori were divided into two groups; those tested using the rapid urease test received empirical BQT (the BQT group) whereas those tested by DPO-PCR received TT (the TT group). Eradication rates, adverse events, and overall medical costs, which included diagnostic test and eradication regimen costs, were compared. Results Three hundred and sixty patients were included in the study (TT group 178, BQT group 182). The modified intention-to-treat eradication rates of BQT and TT were 88.2% (142/161) and 80.3% (118/147), respectively (p=0.055), and corresponding eradication rates in the per-protocol population were 88.8% (142/160) and 81.4% (118/145) (p=0.07). Compliance and adverse event rates were similar in the two groups. Average medical costs were $ 90.3 per patient in the TT group and $ 75.5 in the BQT group (p=0.000). Conclusions Empirical BQT and tailored therapy were similar in terms of H. pylori eradication rate, safety, and tolerability, but BQT was more cost-effective.

scholarly journals Prevalence of Helicobacter pylori colonisation in tonsillar tissue in cases of chronic tonsillitis: a prospective study

2018 ◽  
Vol 4 (3) ◽  
pp. 738
Author(s):  
Vellamparambil Sreejaraj ◽  
Paul Vazhapilly Sumam ◽  
Verghese Nevil ◽  
Karuthedath Sridevi ◽  
Ariyamparampil Rajagopalan Vinayakumar
Keyword(s):  
Helicobacter Pylori ◽  
Tertiary Hospital ◽  
Chronic Tonsillitis ◽  
Rapid Urease Test ◽  
Recurrent Tonsillitis ◽  
Cross Sectional ◽  
Female Ratio ◽  
Tonsillar Tissue ◽  
Urease Test ◽  
H Pylori

<p class="abstract"><strong>Background:</strong> Human stomach is not the only reservoir of <em>Helicobacter pylori</em> but it has been detected in dental plaques, oral lesions and saliva. It could play role in the pathogenesis of various otorhinolaryngologic problems and remains debatable. This study was aimed to find out the prevalence of <em>H. pylori</em> in tonsillar tissue of patients with chronic tonsillitis by rapid urease test in a tertiary hospital in Kerala.</p><p class="abstract"><strong>Methods:</strong> Prospective cross sectional study was done in patients who attended the outpatient department of ENT with a history suggestive of chronic tonsillitis. The patient satisfied the criteria for chronic recurrent tonsillitis were subsequently posted for tonsillectomy. Each specimen was subjected to rapid urease test.  </p><p class="abstract"><strong>Results:</strong> Total 228 patients were included in this study with age ranging between 3 and 31 years (10.0±7.1), with most common age being &lt;10 years in 159 patients (69.7%). Male to female ratio was 1.4:1. Among these, the presence of <em>H. pylori</em> was seen in only 6/228 patients.</p><p class="abstract"><strong>Conclusions:</strong> The possibility of tonsillar tissue acting as a reservoir for <em>H. pylori </em>infection is very low.</p>

scholarly journals Different dose of new generation proton pump inhibitors for the treatment of Helicobacter pylori infection: A meta-analysis

2021 ◽  
Vol 35 ◽  
pp. 205873842110303
Author(s):  
Wenwen Gao ◽  
Xiang Zhang ◽  
Yanhui Yin ◽  
Shuwen Yu ◽  
Lu Wang
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Eradication Rate ◽  
Standard Dose ◽  
Statistical Significance ◽  
High Dose ◽  
Clarithromycin Resistance ◽  
H Pylori ◽  
New Generation

The evidence on whether high-dose new generation proton pump inhibitors (PPIs) including rabeprazole and esomeprazole achieve a higher eradication rate of Helicobacter pylori has not been assessed. The primary comparison was eradication and adverse events (AEs) rate of standard (esomeprazole 20 mg bid, rabeprazole 10 mg bid) versus high-dose (esomeprazole 40 mg bid, rabeprazole 20 mg bid) PPIs. Sub-analyses were performed to evaluate the eradication rate between Asians and Caucasians, clarithromycin-resistance (CAM-R) strains, and clarithromycin-sensitivity (CAM-S) strains of different dose PPIs. We conducted a literature search for randomized controlled trials comparing high-with standard-dose esomeprazole and rabeprazole for H. pylori eradication and AEs. A total of 12 trials with 2237 patients were included. The eradication rate of high-dose PPIs was not significantly superior to standard-dose PPIs regimens: 85.3% versus 84.2%, OR 1.09 (0.86–1.37), P = 0.47. The high dose induced more AEs than those of the standard dose, but didn’t reach statistical significance (OR 1.25, 95% CI: 0.99–1.56, P = 0.06). Subgroup analysis showed that the difference in eradication rate of PPIs between high- and standard-dose groups were not statistically significant both in Asians (OR 0.99, 95% CI 0.75–1.32, P = 0.97) and Caucasians (OR 1.27, 95% CI 0.84–1.92, P = 0.26). Furthermore, there were similar eradication rates in CAM-S (OR 1.2; 95% CI 0.58–2.5; P = 0.63) and CAM-R strains (OR 1.08; 95% CI 0.45–2.56; P = 0.87) between the standard-and high-dose groups. High and standard dosages of new generation of the PPIs showed similar H. pylori eradication rates and AEs as well as between Asian versus Caucasian populations, with or without clarithromycin-resistance. However, further studies are needed to confirm.

Frequency of rdx A Deletion Mutation Conferring Metronidazole Resistance in Helicobacter pylori

2020 ◽  
Vol 29 (3) ◽  
pp. 59-64
Author(s):  
Hanaa M. El Maghraby ◽  
Samar Mohaseb
Keyword(s):  
Helicobacter Pylori ◽  
Epigastric Pain ◽  
Deletion Mutation ◽  
Rapid Urease Test ◽  
Rrna Gene ◽  
University Hospitals ◽  
Metronidazole Resistance ◽  
Urease Test ◽  
Gastric Biopsies ◽  
H Pylori

Background: Metronidazole is one of the antimicrobial drugs that can be used in combination with other drugs for eradication of Helicobacter pylori (H. pylori).Unfortunately, metronidazole resistance in H. plori is an increasing health problem which may be attributed to inactivation of many genes as rdx A gene. Objective: To determine the frequency of rdx A deletion mutation in H. pylori detected in infected patients attending at the Gastroenterology Unit, Zagazig University Hospitals. Methodology: Two gastric biopsies were taken from each enrolled patient by endoscopy. H.pylori detection was done by rapid urease test and polymerase chain reaction (PCR) amplification of 16S rRNA gene. Deletion mutation in rdx A gene was detected by conventional PCR. Results: Out of 134 doubled gastric biopsies obtained from 134 patients, 52.2% were positive for H. pylori. Epigastric pain, vomiting and gastritis were significantly associated with detection of H. pylori infection (p˂ 0.05). Deletion mutation of rdx A gene was detected in 28.6% of H. pylori positive specimens obtained from infected patients. Conclusion: Deletion mutation of rdx A gene is a frequent determinant of rdx A inactivation conferring metronidazole resistance among H. pylori.

scholarly journals Incidence of Gastric Metaplasia and Helicobacter pylori Infection in Duodenal Bulb – With Specific Reference to Patients With Duodenal Ulcers

1999 ◽  
Vol 6 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Minoru Kawaguchi ◽  
Toshihiko Saito
Keyword(s):  
Helicobacter Pylori ◽  
Duodenal Bulb ◽  
Mucosal Injury ◽  
Transitional Zone ◽  
Specific Reference ◽  
Rapid Urease Test ◽  
Duodenal Ulcers ◽  
Gastric Metaplasia ◽  
Urease Test ◽  
H Pylori

We determined the incidence of gastric metaplasia in the duodenal bulb of duodenal ulcer patients and the Helicobacter pylori (H. pylori) infection rate at sites with gastric metaplasia. Biopsy of the duodenal bulb showed the presence of gastric metaplasia in 61 of 86 patients (71%) overall and in 18 of 47 patients (38.3%) who had gastrectomy at an early gastric cancer. The histological diagnosis of H. pylori infection showed good agreement (83.3%) with the result of the rapid urease test, indicating that H. pylori occurs in regions with gastric metaplasia. This finding suggests that H. pylori infects gastric metaplasia in the duodenal bulb, causing mucosal injury, which is then transformed into duodenal ulcers. The exact mechanism by which gastric metaplasia is caused is unknown, but it is believed to occur in the transitional zone in the duodenal mucosa.

scholarly journals Association of gastric infection and periodontal disease through Helicobacter pylori as a common denominator: A systematic review and meta-analysi

2021 ◽  
Author(s):  
Nansi López-Valverde ◽  
◽  
Antonio López-Valverde ◽  
Ana Suarez ◽  
Bruno Macedo de Sousa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Helicobacter Pylori ◽  
Clinical Studies ◽  
Periodontal Diseases ◽  
Meta Analysis ◽  
Helicobacter Pylori Infection ◽  
Enzyme Linked Immunosorbent Assay ◽  
Rapid Urease Test ◽  
Common Denominator ◽  
Urease Test

Review question / Objective: Is gastric helicobacter pylori infection related to periodontal diseases? Condition being studied: Therefore, the aim of this systematic review and meta-analysis was to identify and analyze clinical studies to determine the direct correlation between Helicobacter Pylori gastric infection andPeriodontal Disease. Study designs to be included: Clinical studies that provided data on Helicobacter Pylori infection in both the stomach and oral cavity, confirmed by polymerase chain reaction (PCR), rapid urease test (RUT) or enzyme-linked immunosorbent assay (ELISA). Clinical studies that associated PD with Helicobacter Pylori. The diagnosis of PD was confirmed ac-cording to the diagnostic criteria in periodontology.

scholarly journals Can probiotics improve efficiency and safety profile of triple Helicobacter pylori eradication therapy? A prospective randomized study

2016 ◽  
Vol 73 (11) ◽  
pp. 1044-1049 ◽  
Author(s):  
Sasa Grgov ◽  
Tomislav Tasic ◽  
Biljana Radovanovic-Dinic ◽  
Daniela Benedeto-Stojanov
Keyword(s):  
Helicobacter Pylori ◽  
Randomized Study ◽  
Eradication Therapy ◽  
Saccharomyces Boulardii ◽  
Rapid Urease Test ◽  
Group I ◽  
Urease Test ◽  
Probiotic Strains ◽  
The Difference ◽  
H Pylori

Background/Aim. Some studies suggest the benefit of applying different probiotic strains in combination with antibiotics in the eradication of Helicobacter pylori (H. pylori) infection. The aim of this study was to evaluate the effect of co-administration of multiple probiotic strains with triple H. pylori eradication therapy. Methods. This prospective study included 167 patients with dyspeptic symptoms and chronic gastritis who were diagnosed with H. pylori infection and randomized into two groups. The group I of 77 patients underwent triple eradication therapy, for 7 days, with lansoprazole, 2 ? 30 mg half an hour before the meal, amoxicillin 2 ? 1.000 mg per 12 hours and clarithromycin 2 ? 500 mg per 12 hours. After the 7th day of the therapy, lansoprazole continued at a dose of 30 mg for half an hour before breakfast for 4 weeks. The group II of 90 patients received the same treatment as the patients of the group I, with the addition of the probiotic cultures in the form of a capsule comprising Lactobacillus Rosell-52, Lactobacillus Rosell-11, Bifidobacterium Rosell-1755 and Saccharomyces boulardii, since the beginning of eradication for 4 weeks. Eradication of H. pylori infection control was performed 8 weeks after the therapy by rapid urease test and histopathologic evaluation of endoscopic biopsies or by stool antigen test for H. pylori. Results. Eradication of H. pylori infection was achieved in 93.3% of the patients who received probiotics with eradication therapy and in 81.8% of patients who were only on eradication therapy without probiotics. The difference in eradication success was statistically significant, (p < 0.05). The incidence of adverse effects of eradication therapy was higher in the group of patients who were not on probiotic (28.6%) than in the group that received probiotic (17.7%), but the difference was not statistically significant. Conclusion. Multiple probiotic strains addition to triple eradication therapy of H. pylori achieves a significantly better eradication success, with fewer side effects of antibiotics.

Sign in / Sign up

Export Citation Format

Share Document