EFFICACY OF RACM REGIMEN ON HELICOBACTER PYLORI ERADICATION IN PATIENTS OF CHRONIC GASTRITIS

2016 ◽  
pp. 88-93
Author(s):  
Thi Hoai Thai ◽  
Van Huy Tran

Background: H. pylori eradication still remains a challenge to clinicians, especially with the increasing antibiotic-resistant H. pylori. Concomitant therapy showed effective, even in some multiresistant population, but data in Vietnam is still very limited. The study ''Study of Helicobacter pylori eradication with RACM regimen in chronic gastritis patients at Da Nang Hospital from 1/4/2014 to 30/6/2015, is aimed at: (1) Evaluating the results of Helicobacter pylori eradication of Amoxicillin-Clarithromycin-Rabeprazole-Metronidazole therapy for 14 days.(2) Assessing some side effects of this regimen.Method: prospective, consisting of 83 patients examined and treated in Danang hospital from1/ 4/2014 to 30/6/2015, H.pylori was tested by rapid Urease test; H.pylori positive patients received RACM for 14 days. Results: H.pylori eradication rate was 83.1%. H. pylori eradication rates in different locations: antrum 63.8%, higher than corpus (17.4%), antrum and corpus (18.8%), with statistical significance at p<0.05. Common side effects was nausea (27.7%), diarrhea (19.3%). Abdominal pain, lightheadedness, dizziness, insomnia, headache account for low percentage: 8%; 6%; 3,6% and 2.4% respectively. Conclusion: The effect of 14 day RACM regimen for H. pylori eradication was 83.1%, common side effects are nausea (27.7%), diarrhea (19.3%). Key words: chronic gastritis;H. pylori; eradication of H. pylori(ITT); RACM regimen.

2016 ◽  
pp. 31-35
Author(s):  
Van Huy Tran ◽  
Thi Minh Trieu Nguyen

Background: Quadruple therapy with bismuth was considered as a promising regimen in the eradication of Helicobacter pylori in the population with clarithromycine- resistant high rate, but data in Vietnam was still limited. This study is aimed at determining the eradication rate of quadruple regimen and its side effects in the patients with chronic gastritis. Patients and methods: 98 patients with chronic gastritis histologically diagnosed and postive with rapid urease test were enrolled. Patients received Rabeprazole 20 mg bid, Pepto bismol 2tab bid, tetracyclin 1000 mg bid and Metronidazole 550 mg bid for 10 days. Results: Eradication rates of quadruple regimens with bismuth were 91.8% in ITT analysis and 94.7% in PP analysis. Rate of compliance was 96.9%. The side effects were minor and transient. Conclusion: Quadruple regimen with bismuth showed a high rate of H. pylori eradication and a good tolerance in patients with chronic gastritis in central Vietnam. Key words: Helicobacter pylori, quadruple regimen, bismuth


2016 ◽  
pp. 149-158
Author(s):  
Ngoc Quy Hue Dang ◽  
Van Huy Tran ◽  
Thanh Hai Nguyen

Background: there has not been yet any research on the effectiveness of H. pylori eradication of bismuth-containing quadruple regimen on chronic gastritis patients in our country. Objective: to evaluate H. pylori eradication rate of bismuth-containing quadruple regimen according to intention to treat (ITT), per protocol (PP) analysis, the rate of side effects and medication compliance. Subjects and Methods: from March 2014 to January 2016 we used bismuth-containing quadruple regimen (EBMT) 10 days for H. pylori eradication therapy for 166 chronic gastritis patients diagnosed based on clinical, endoscopic, rapid urease test, histology and culture. Patients were evaluated side effects and medication compliance at the end of treatment (day 11-14). To assess the eradication, repeating endoscopy with both rapid urease test and histological examination were performed at 4 to 8 weeks after stopping treatment course. Results: H. pylori eradication rates on ITT and PP analysis overall, for naïve patients, after one and more two eradication failures were respectively: 80.72-89.33%, 79.51-90.65%, 91.67-91.67% and 75.00-78.95%. Medication adherence rate was 96.99%. The rates of patients experiencing moderate, severe and very severe side effects were: 19.88%, 0.60% and 1.81%. Conclusion: the EBMT 10-day regimen attained high eradication rates in chronic gastritis patients with rare serious side effects and the high compliance rate. We should apply bismuth-containing quadruple regimen in H. pylori eradication therapy for naïve patients or after one eradication failure. Key words: bismuth-containing quadruple regimen, EBMT, eradication, chronic Helicobacter pylori gastritis


Author(s):  
Mariana E. Maioli ◽  
Raquel F. N. Frange ◽  
Cintia M. C. Grion ◽  
Vinicius D. A. Delfino

Abstract Introduction: Treatment for Helicobacter pylori (H. pylori) infection is recommended in transplant candidates due to the association between this infection and gastrointestinal disorders, which could significantly increase morbidity after renal transplantation with the use of immunosuppression. The objective of this study was to analyze the rate of eradication of H. pylori after antimicrobial treatment in chronic kidney disease patients who are candidates for kidney transplantation. Methods: A multicenter prospective cohort study was conducted. All adult chronic kidney disease patients seen at our institution were included. In the pre-transplantation evaluation, 83 patients underwent an upper gastrointestinal endoscopy with 2 diagnostic methods to detect H. pylori: histology and the rapid urease test. In total, 33 patients with H. pylori infection received treatment with 20 mg omeprazole, 500 mg amoxicillin, and 500 mg clarithromycin once daily for 14 days. Another upper gastrointestinal endoscopy was performed 8 to 12 weeks after the end of treatment to check for healing. Results: The study showed a prevalence of H. pylori in 51 (61.4%) patients. Histology was positive in 50 (98%) patients and the rapid urease test was positive in 31 (60.8%). The infection eradication rate was 48.5% (16 patients). Conclusions: There was a high prevalence rate of H. pylori and a low eradication rate after the long-term antimicrobial triple scheme used. The association of the rapid urease test with gastric mucosa histology did not increase the detection rate of H. pylori.


2007 ◽  
Vol 56 (8) ◽  
pp. 1081-1085 ◽  
Author(s):  
Lyudmila Boyanova ◽  
Elena Lazarova ◽  
Christo Jelev ◽  
Galina Gergova ◽  
Ivan Mitov

The aims of the study were to evaluate the incidence of Helicobacter pylori and Helicobacter heilmannii in untreated Bulgarian children from 1996 to 2006, to analyse the performance of diagnostic tests, and to look at H. pylori density in specimens by culture. Antral specimens from children with chronic gastritis (n=513), peptic ulcers (n=54) and other diseases (n=91) were evaluated by direct Gram staining (DGS), in-house rapid urease test (RUT) and culture. The living environment and semi-quantitative H. pylori density were assessed in 188 and 328 children, respectively. H. pylori infection was found in children with ulcers (77.8  %), chronic gastritis (64.5  %) and other diseases (36.3  %). Half (51.4  %) of patients aged 1–5 years and 77.4  % of those aged 16–17 years were H. pylori-positive. Of all children, 328 (49.8  %) showed positive DGS, 184 (28  %) had a positive RUT, and 386 (58.7  %) were culture-positive. Unlike gastric mucus specimens, frozen biopsy specimens provided reliable diagnosis. H. heilmannii was observed in two (0.3  %) children. High H. pylori density (growth into all quadrants of plates) was found in 18  % of 328 children evaluated, involving 31  % of ulcer and 16.7  % of non-ulcer patients. H. pylori infection was more common in rural children with chronic gastritis (91.3  %) than in the remainder (66.7  %). In conclusion, H. pylori infection was common in symptomatic Bulgarian children. The infection prevalence was >77  % in patients aged 16–17 years, in children with a duodenal ulcer, and in rural patients. H. heilmannii infection was uncommon. The performance of the bacterial culture was good. The impact of H. pylori density on the clinical expression and eradication of the infection requires further evaluation. The results highlight the need for routine H. pylori diagnosis in rural children with chronic gastritis.


Digestion ◽  
2019 ◽  
Vol 101 (6) ◽  
pp. 779-784 ◽  
Author(s):  
Takunori Ueno ◽  
Hideo Suzuki ◽  
Mitsuaki Hirose ◽  
Takashi Shida ◽  
Kazuto Ikezawa ◽  
...  

<b><i>Introduction:</i></b> <i>Helicobacter pylori</i> infection is usually established during childhood, for which certain responsible environmental factors have been identified. However, the details of the infection routes remain unclear. <b><i>Objective:</i></b> To determine the relation between <i>H. pylori</i> infection statuses and living environment of Japanese young adult. <b><i>Methods:</i></b> The subjects were 449 healthy young adult medical students of Tsukuba University (299 men and 150 women, mean age: 22.8 years). The <i>H. pylori</i> infection statuses were investigated using the rapid urease test or urine antibody. Questionnaires regarding sanitary conditions including usage of pit toilet or well water and experience of living with one’s grandparents during childhood were surveyed. Each item was compared between the <i>H. pylori</i>-positive and -negative groups. <b><i>Results:</i></b> Among all participants, 33 (7.3%) were <i>H. pylori</i>-positive. The usage rates of pit toilets were 12.1 and 3.1% for the <i>H. pylori</i>-positive and -negative groups respectively (<i>p</i> = 0.03; OR 4.35, 95% CI 1.33–14.22). The usage rates of well water were 24.2 and 13.7% for the <i>H. pylori</i>-positive and -negative groups respectively (<i>p</i> = 0.07; OR 2.12, 95% CI 0.91–4.98). The proportion of participants with a history of living with their grandparents was significantly greater in the <i>H. pylori</i>-positive group (46.7%) than in the -negative group (20.9%; <i>p</i> = 0.03; OR 3.28, 95% CI 1.13–9.54). Only a history of living with one’s grandparents during childhood showed statistical significance in the multivariate regression analysis (<i>p</i> = 0.04; OR 3.20, 95% CI 1.08–9.49). <b><i>Conclusions:</i></b> These results suggest that <i>H. pylori</i> infection is more strongly related to living with one’s grandparents than living in a hygienic environment.


2002 ◽  
Vol 57 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Fernando Marcuz Silva ◽  
Jaime Natan Eisig ◽  
Ethel Zimberg Chehter ◽  
Júlio Jovino da Silva ◽  
Antonio Atílio Laudanna

PURPOSE: To determine the eradication rate of an ultra-short treatment schedule for Helicobacter pylori infection in a population with peptic ulcers, using omeprazole, secnidazole, and azithromycin in a once-daily dose for 3 days. METHODS: Thirty patients with peptic ulcer diagnosed by upper endoscopy and for Helicobacter pylori infection by rapid urease test and histologic examination received omeprazole 40 mg, secnidazole 1000 mg, and azithromycin 500 mg, administered once daily for 3 days. A follow-up exam was performed 12 weeks after the end of the treatment. Patients who were negative for Helicobacter pylori infection by rapid urease test and histologic examination were considered cured. RESULTS: Patients were predominantly female, and the mean age was 50 years. Duodenal peptic ulcer was found in 73% of the patients. Eradication was achieved in 9 of the 28 (32%) patients as determined from the follow-up endoscopic exam. The eradication rate by intention to treat was 30%. Side effects were present in 3% of the patients, and compliance to treatment was total. CONCLUSIONS: In spite of the low rate of side effects and good compliance, the eradication index was low. A possible drawback of this therapy is that it reduces the efficacy of macrolide and nitroimidazole compounds in subsequent treatments.


2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Shinah A. Mohammed ◽  
Omer Q. B. Al-lela ◽  
Nawfal R. Hussein ◽  
Ramadhan S. Hajany ◽  
Laween S. Alduhoky

Helicobacter pylori infection is a predisposing factor for gastric cancer. This prospective, randomized clinical trial aimed to compare H. pylori eradication rates associated with a clarithromycin-based regimen and levofloxacin-based regimen. H. pylori infection was confirmed by a rapid urease test during endoscopy and its eradication by a urea breath test. In this study, 192 patients were recruited; 93 patients received a clarithromycin- based regimen and 99 a levofloxacin- based regimen. Sixty-four patients completed the clarithromycinbased regimen and 60 the levofloxacinbased regimen. The eradication success rate of the clarithromycin-based regimen was 52/64 (81.25%), while that of the levofloxacin- based regimen was 49/60 (81.6%) (P=0.9524; odds ratio [OR]=1.0280; confidence interval [CI]=0.4153-2.5447). Investigation of the risk factors associated with treatment failure showed that the overall efficacy of the regimens was influenced by body mass index (BMI), with a high failure rate observed in patients with a high BMI (P=0.0174; OR=1.1116; CI=1.0187- 1.2129). Age, sex, endoscopic diagnosis and smoking did not influence treatment outcomes. Further studies are needed to monitor H. pylori antibiotic resistance rates.


Author(s):  
H. B. Isayev ◽  
M. R. Ibrahimov ◽  
T. H. Salimov

Introduction. The aim of the study was to detect the dependence of the composition of the parietal microflora of the colon on the activity of Helicobacter pylori-associated chronic gastritis and the degree of Helicobacter pylori contamination of the gastric mucosa. Materials and methods. The study was carried out on 50 patients aged 24 to 72 years, who were diagnosed with HP-associated chronic gastritis in the phase of exacerbation based on the results of FEGDS and histological examination of biopsies of the mucous membrane of the antrum of the stomach in combination with a rapid urease test. A series of dilutions 10¹-10⁹ was prepared from a homogenized biopsy specimen of the mucous membrane of the sigmoid colon in 0.1 ml of isotonic sodium chloride solution, and 0.1 ml of a solution of the corresponding dilution was inoculated onto the surface of the nutrient medium. The study of mucosal microflora was carried out by means of bacteriological examination of biopsies of the mucous membrane of the sigmoid and cecum. The degree of H. pylori contamination of the gastric mucosa was assessed in the course of histological examination by a semi-quantitative method: low degree of contamination — up to 20 microbial bodies, average — 20-50 microbial bodies, strong — over 50 microbial bodies in the field of view. Results. The study demonstrated that the indicators of the average concentrations of bifidobacteria, lactobacilli and typical strains of E. coli progressively decreased with the transition to a higher degree of HP infection. This tendency was maximum in relation to bifidobacteria — 6.1-1.57-1.09 x 10⁸ CFU/g, with a difference between the maximum (I degree) and minimum (III degree) 5.59 times. A similar relationship, but much less pronounced, was observed for Lactobacterium spp. and E. coli. As the severity of HP infiltration of the gastric mucosa increases, there is a decrease in the concentration of the above microorganisms in the parietal mucin - the correlation coefficient is r = -0.74. Discussion. Since the mucous microflora is more stable and functionally significant than the cavity microflora, the data obtained allow us to consider Helicobacter pylori as an etiological factor of colonic dysbiosis. Conclusion. The probability of excessive growth of conditionally pathogenic fraction of intestinal parietal microflora has a direct dependence on the severity of Helicobacter pylori infestation, being maximum at degree III contamination. Content of bifidobacteria, lactobacilli and typical E. coli strains in the intestinal biotope of the large intestine is inversely related to the degree of histological activity of HP-associated gastritis.


2020 ◽  
Vol 1 (1) ◽  
pp. 10-13
Author(s):  
Subash Bhattarai ◽  
Chandra Prasad Acharya ◽  
Sudeep Regmi

Background: Helicobacter pylori (H. pylori) is associated with the pathogenicity of gastro-duodenal ulcers and gastric cancers. Combination of several antimicrobial therapies and regimens have been advised for H. pylori treatment. But, resistance to various antibiotics regimens are being documented worldwide. The present study was undertaken to study the efficacy of commonly used 3 different regimens for eradication of H.pylori infection in Nepalese patients. Methods: A cross-sectional, hospital based study comprising of 405 subjects, was conducted. Each study patient underwent upper gastro-intestinal endoscopy followed by rapid urease test or histopathology from the biopsy sample for H. pylori detection. Patients were randomly subjected to 3 different H. pylori eradication regimen.  After 4 weeks of therapy, patients were re-evaluated for persistence of H. pylori infection either by repeat UGI endoscopy followed by RUT or C14- Urea Breadth Test. Data analysis was done by SPSS 20. Results: Mean age of the patients was 34.4±8.72 years (M: F=1.5:1) with male predominance. H. pylori eradication rate was only 65.9% in patients using standard triple regimen using Amoxicillin, Clarithromycin and PPI (Group A). Eradication rate was greater (77.8%) with Levofloxacin based regimen (Group B) and 83.3%. with sequential regimen containing Amoxicillin followed by Clarithromycin and Tinidazole with PPI (Group C). Conclusion: The study demonstrates that the current standard Amoxicillin and Claritrhromycin based triple regimen has lowest eradication rate followed by levofloxacin based regimen. The sequential regimen was the most efficacious among the 3 different regimens for H. pylori eradication.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4442-4442
Author(s):  
Ji Yoon Kim ◽  
Yong-Mook Choi ◽  
Kun Soo Lee

Abstract Abstract 4442 Purpose For hemophiliacs gastrointestinal hemorrhage is a life-threatening complication and can be caused by the Helicobacter pylori infection. In this study, the prevalence of H. pylori infection among child hemophiliacs with gastrointestinal hemorrhage and the recurrence rate after eradication H. pylori treatment was investigated. Patients and Methods Seven children with hemophilia A with hematemesis (age, 5.3∼17.0 year) were evaluated for the causes of gastrointestinal hemorrhage and the detection of H. pylori. Gastroendoscopy was done to find the bleeding focus and for further evaluation including rapid urease test and mucosal biopsy. Result: Four patients had dyspepsia and abdominal pain for several weeks or months prior to hematemesis. Three patients did not show any signs of bleeding. From gastroendoscopy, four patients were diagnosed as duodenal ulcer, one as H. pylori associated chronic gastritis and one as hemorrhagic gastritis. One patient showing a normal finding was diagnosed with adenoid hemorrhage after nasopharyngoscopy. H. pylori infection was found in four of six patients with GI bleeding (3, duodenal ulcer; 1, H. pylori associated chronic gastritis). The patients with H. pylori infection had an eradication treatment of triple therapy and no recurrence happened. Conclusion In child hemophiliacs, H. pylori should also be considered as an important cause of gastrointestinal hemorrhage. The recurrence of the infection and gastrointestinal hemorrhage can be prevented with eradication of H. pylori. Screening test for H. pylori would be needed in child hemophiliacs in endemic area. Disclosures: No relevant conflicts of interest to declare.


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