scholarly journals Impact of Age, Gender, and Addition of Probiotics on Treatment Success for Helicobacter pylori in Children

2015 ◽  
Vol 2 ◽  
pp. 2333794X1560779 ◽  
Author(s):  
Noam Weiner ◽  
Ron Shaoul
Keyword(s):  
Helicobacter Pylori ◽  
Treatment Success ◽  
Primary Objective ◽  
Line Treatment ◽  
Second Line ◽  
Helicobacter Pylori Eradication ◽  
Standard Triple Therapy ◽  
Probiotic Treatment ◽  
H Pylori ◽  
Standard Treatment Regimen

The primary objective of this study was to evaluate the effect of age, gender, and the use of probiotics with standard treatment regimen on Helicobacter pylori eradication. Based on endoscopic findings and clinical presentation, selected patients were treated with standard triple therapy (omeprazole, clarithromycin, and amoxicillin). Those who failed were offered a repeat treatment with omeprazole, metronidazole, and amoxicillin. After the publications of the possible advantages of probiotic treatment on H pylori eradication, the probiotic agent “Probiotica Forte” was routinely added to the treatment. Eradication was noted for 94/130 patients (72%) and for 128/197 patients (65%) with or without probiotic agent, respectively ( P = .23). For second-line treatment eradication was noted in 33/46 (72%) and in 9/20 (45%) with or without probiotic agent, respectively ( P = .053). The addition of probiotics may improve eradication success especially in addition to second-line treatment.

scholarly journals Efficacy of Twice a Day Bismuth Quadruple Therapy for Second-Line Treatment of Helicobacter pylori Infection

2022 ◽  
Vol 12 (1) ◽  
pp. 56
Author(s):  
Jeemyoung Kim ◽  
Eun Jeong Gong ◽  
Myeongsook Seo ◽  
Hyun Il Seo ◽  
Jong Kyu Park ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Eradication Therapy ◽  
Helicobacter Pylori Infection ◽  
Adverse Event Rate ◽  
Line Treatment ◽  
Second Line ◽  
Current Smoking ◽  
Quadruple Therapy ◽  
Standard Triple Therapy ◽  
H Pylori

Bismuth quadruple therapy (BQT) is an effective treatment for Helicobacter pylori infection. However, frequent dosing schedules of BQT regimen often compromise drug adherence and may affect treatment outcomes. This retrospective study aimed to investigate the efficacy of twice-daily BQT compared to that of four times a day therapy. From August 2018 to November 2020, adult patients who failed first-line standard triple therapy and underwent BQT were eligible. Patients were categorized into two groups according to dosing schedule: (i) the BQT group (n = 213) who received standard BQT administered four times a day; and (ii) the BQTb group (n = 141) who received proton pump inhibitor, bismuth 600 mg, metronidazole 500 mg, and tetracycline 1 g twice a day. The eradication rate did not differ between the BQT (92.5%) and the BQTb groups (90.1%) (p = 0.441). Adherence and adverse event rate were similar between the two groups. Multivariate analysis showed that current smoking was associated with eradication failure; however, dosing frequency was not associated with the efficacy of eradication therapy. This study suggested that twice a day BQT is as effective as four times a day therapy for second-line treatment of H. pylori infection.

10 days levofloxacin-based triple therapy in second-line treatment for Helicobacter pylori eradication

2003 ◽  
Vol 124 (4) ◽  
pp. A359 ◽  
Author(s):  
Enrico C. Nista ◽  
Immacolata A. Cazzato ◽  
Simona Di Caro ◽  
Marcello Candelli ◽  
Veronica Ojetti ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Line Treatment ◽  
Second Line ◽  
Helicobacter Pylori Eradication

scholarly journals Best Helicobacter pylori Eradication Strategy in the Era of Antibiotic Resistance

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 436 ◽  
Author(s):  
Su Young Kim ◽  
Jun-Won Chung
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Resistance Rate ◽  
First Line ◽  
Helicobacter Pylori Eradication ◽  
First Line Therapy ◽  
Standard Triple Therapy ◽  
Eradication Strategy ◽  
Helicobacter Pylori Treatment ◽  
H Pylori

Antibiotic resistance is the major reason for Helicobacter pylori treatment failure, and the increasing frequency of antibiotic resistance is a challenge for clinicians. Resistance to clarithromycin and metronidazole is a particular problem. The standard triple therapy (proton pump inhibitor, amoxicillin, and clarithromycin) is no longer appropriate as the first-line treatment in most areas. Recent guidelines for the treatment of H. pylori infection recommend a quadruple regimen (bismuth or non-bismuth) as the first-line therapy. This treatment strategy is effective for areas with high resistance to clarithromycin or metronidazole, but the resistance rate inevitably increases as a result of prolonged therapy with multiple antibiotics. Novel potassium-competitive acid blocker-based therapy may be effective, but the data are limited. Tailored therapy based on antimicrobial susceptibility test results is ideal. This review discussed the current important regimens for H. pylori treatment and the optimum H. pylori eradication strategy.

scholarly journals Evaluation of the Effectiveness of Helicobacter pylori Eradication Regimens in Lithuania during the Years 2013–2020: Data from the European Registry on Helicobacter pylori Management (Hp-EuReg)

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 642
Author(s):  
Paulius Jonaitis ◽  
Juozas Kupcinskas ◽  
Olga P. Nyssen ◽  
Ignasi Puig ◽  
Javier P. Gisbert ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Diagnostic Methods ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Intention To Treat ◽  
H Pylori ◽  
Cure Rates ◽  
European Registry

Background and Objectives: The prevalence of H. pylori in Eastern Europe remains quite high; however, there is insufficient data on the eradication regimens and their effectiveness. Therefore, the objective of the study was to evaluate the diagnostic methods and treatment of H. pylori infection as well as their adherence to Maastricht V/Florence consensus during the years 2013–2020 in Lithuania. Materials and Methods: Sub-study of the “European Registry on H. pylori Management” (Hp-EuReg), international multicenter prospective non-interventional registry of the routine clinical practice. Lithuanian data from the years 2013–2020 were analyzed for effectiveness on a modified intention-to-treat (mITT) basis. 2000 adult patients, diagnosed with H. pylori infection, were included. Data were compared to the European Maastricht V guidelines. Results: Triple-therapy was used in 90% of the cases. In 91% of the first-line prescriptions, standard triple therapy (STT) was used. The most common second-line treatment was a combination of PPI, amoxicillin and levofloxacin (PPI+A+L) (47%). The overall effectiveness in 552 cases valid for analysis was 90% by mITT. In first-line treatment, the STT effectiveness was 90% and second-line treatment with PPI+A+L achieved 92% by mITT. Increasing overall H. pylori eradication rates were observed: from 72% in 2013 to more than 90% in 2018–2020, as well as a shift from 7 to 10–14 days treatments duration throughout 2013–2020. Conclusions: In Lithuania, the prescribed eradication regimens for H. pylori were in accordance with the international guidelines but diagnostic methods and treatment duration only partially met Maastricht V/Florence guidelines. The eradication effectiveness was improved progressively during the years 2018–2020, reaching ≥90% cure rates.

scholarly journals Effect of Antibiotic Susceptibility and CYP3A4/5 and CYP2C19 Genotype on the Outcome of Vonoprazan-Containing Helicobacter pylori Eradication Therapy

Antibiotics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 645
Author(s):  
Mitsushige Sugimoto ◽  
Daiki Hira ◽  
Masaki Murata ◽  
Takashi Kawai ◽  
Tomohiro Terada
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Susceptibility ◽  
Eradication Rate ◽  
Eradication Therapy ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Helicobacter Pylori Eradication ◽  
Third Line ◽  
Third Line Treatment

Background: Helicobacter pylori eradication containing the potassium-competitive acid blocker, vonoprazan, achieves a higher eradication rate than therapy with proton pump inhibitors (PPIs). Because vonoprazan is mainly metabolized by CYP3A4/5, CYP genotype may affect the eradication rate. We investigated the influence of antibiotic susceptibility and CYP3A4/5 and CYP2C19 genotypes on the eradication rates. Methods: A total of 307 Japanese who were genotyped for CYP3A4 *1/*22, CYP3A5 *1/*3 and CYP2C19 *1/*2/*3/*17, and investigated for susceptibility to antimicrobial agents, received vonoprazan-containing regimens: (1) With amoxicillin and clarithromycin as the first-line treatment; (2) with amoxicillin and metronidazole as the second-line treatment; or (3) with amoxicillin and sitafloxacin as the third-line treatment. Results: The eradication rate was 84.5% (95% confidence interval [CI]: 78.9–89.1%) using first-line, 92.6% (95% CI: 82.1–97.9%) using second-line and 87.5% (95% CI: 73.1–95.8%) using third-line treatment. Infection with clarithromycin-resistant strains was a predictive factor for failed eradication (odds ratio: 5.788, 95% CI: 1.916–17.485, p = 0.002) in multivariate analysis. No significant differences were observed in the eradication rate of regimens among CYP3A4, CYP3A5 and CYP2C19 genotypes. Conclusions: Genotyping for CYP3A4 *1/*22, CYP3A5 *1/*3 and CYP2C19 *1/*2/*3/*17 before vonoprazan-containing eradication treatment may not be useful for predicting clinical outcomes.

scholarly journals Proton Pump Inhibitor Switching Strategy after Failure of Standard Triple Therapy for Helicobacter pylori Infection

2020 ◽  
Vol 20 (2) ◽  
pp. 146-152
Author(s):  
Jaeyoung Kim ◽  
Yeon-Ji Kim ◽  
Woo Chul Chung
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Triple Therapy ◽  
Proton Pump ◽  
Eradication Rate ◽  
Control Group ◽  
Second Line ◽  
Observation Study ◽  
Standard Triple Therapy ◽  
H Pylori

Background/Aims: It is still unknown whether cytochrome P450 (CYP) 2C19 polymorphisms influence <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication, especially in eastern Asia. We aimed to evaluate how changes in proton pump inhibitor (PPI) strategies could be used to overcome the effects of CYP2C19 polymorphism on <i>H. pylori</i> eradication rate when it is used as the second-line regimen after the failure of standard triple therapy.Materials and Methods: We performed a retrospective observation study of 675 patients in whom standard triple therapy for <i>H. pylori</i> infection was not effective between January 2009 to December 2018. All patients underwent a classic bismuth-containing quadruple therapy (10 to 14-day regimen), and their eradication rates were evaluated for several years. We compared the eradication rates in patients with or without the second-line PPI switch. Further, we assessed differences in eradication rates with or without the strategy using esomeprazole and rabeprazole, which are not influenced significantly by CYP2C19 genetic polymorphism.Results: The eradication rate was 81.0% in individuals who received the second-line PPI switch, but it was 74.8% without switching (<i>P</i>=0.14). In the strategy using esomeprazole and rabeprazole, the eradication rate was 84.6%, compared to 76.5% in the control group (<i>P</i>=0.03). Finally, in the group of patients who switched to rabeprazole, the eradication rates were 85.6%, compared to 77.6% in the group who switched to pantoprazole (<i>P</i>=0.05).Conclusions: Switching to PPI, which is not influenced by CYP2C19 genetic polymorphism, increases the efficiency of eradication after the failure of standard triple therapy.

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