CHRONIC HELICOBACTER PYLORI GASTRITIS: THE ERADICATION EFFICACY OF THE BISMUTH-CONTAINING QUADRUPLE REGIMEN (EBMT)

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

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 ◽  
Vol 73 (11) ◽  
pp. 1044-1049 ◽  
Author(s):  
Sasa Grgov ◽  
Tomislav Tasic ◽  
Biljana Radovanovic-Dinic ◽  
Daniela Benedeto-Stojanov

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.


2020 ◽  
Vol 92 (8) ◽  
pp. 52-59
Author(s):  
S. R. Abdulkhakov ◽  
D. S. Bordin ◽  
R. A. Abdulkhakov ◽  
D. D. Safina ◽  
A. R. Gizdatullina ◽  
...  

Background. As part of an observational multicenter prospective study European Registry on the management of Helicobacter pylori infection, conducted on the initiative of the European H. pylori and Microbiota Study Group, the compliance of clinical practice in the management of patients with Helicobacter pylori infection in Kazan with clinical guidelines was assessed. Materials and methods. The data of 437 patients included into the register by clinical sites in Kazan in 20132019 were analyzed. The methods used for the initial diagnosis of H. pylori infection and eradication control were evaluated. The frequency of various eradication therapy regimens prescription was analyzed in 379 cases. Data regarding the effectiveness of eradication therapy was analyzed in 173 patients. Results. The rapid urease test (44.2% of cases) and cytology/histology (60% of cases) were most often used for the initial diagnosis of H. pylori infection; however non-invasive methods such as 13C-urea breath (9.2%), serology (6.2%), H. pylori stool antigen test (2.3%) were less common. In 21.7% of patients two methods of H. pylori detection were used for primary diagnosis. The control test to evaluate the effectiveness of eradication therapy at the recommended timepoint was performed in 46.2% of patients. 13C-urea breath test (31.7%), stool PCR/stool antigen test (28.7%), rapid urease test (22.3%), cytology/histology (26.2% of cases) prevailed in the assessment of eradication rate. Standard triple therapy, including proton pump inhibitor, clarithromycin and amoxicillin was most commonly prescribed as first-line therapy (64.6% of cases). The duration of eradication therapy was 14 days in the majority of cases with pantoprazole as the most common proton pump inhibitor in standard triple therapy regimens (84.8%). The efficacy of 14-day standard triple therapy (mITT) was 87.0%. Conclusion. The results indicate a high frequency of non-invasive methods use for assessing the effectiveness of eradication therapy; however, the overall rate of eradication efficacy assessment is low, limiting the possibility of analyzing the eradication results. The effectiveness of the most common 14-day standard triple first-line therapy in Kazan doesnt reach the recommended 90% eradication level. This could be explained by high rate of pantoprazole use, which is not an optimal proton pump inhibitor in eradication therapy regimens.


2018 ◽  
Vol 90 (2) ◽  
pp. 35-42 ◽  
Author(s):  
D S Bordin ◽  
Yu V Embutnieks ◽  
L G Vologzhanina ◽  
T A Il'chishina ◽  
I N Voinovan ◽  
...  

On behalf of the scientific Committee and researchers Hp-EuReg European Registry on the management of Helicobacter pylori infection («Hp-EuReg») - a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group, conducted in 27 European countries in order to evaluate the real clinical practice of diagnosis and treatment of H. pylori and its comparison with international recommendations. Materials and methods. The analysis of 2360 patients entered in the register by the Russian centres of «Hp-EuReg» in 2013-2017, who were underwent 1st line eradication therapy. Results. The most common methods of primary diagnosis of H. pylori are histological (37.7%), rapid urease test (29.2%) and serology (29.7%). The duration of eradication therapy in 9.4% of cases was 7 days, in 65.3% - 10 days, and in 25.3% - 14 days. To control the effectiveness of treatment, H. pylori antigen in feces (31.3%), urea breath test (23.4%) and histological method (23.3%) were used. In 3.6% cases was used serology by mistake. In 17.3% of patients control was not carried out. The effectiveness of triple therapy with a PPI, amoxicillin, clarithromycin (per protocol) was 67.6%, with 7-day course, 81.1% at 10-day and 86.7% at 14-day course. Еradication rate of triple therapy with addition of bismuth (per protocol) reached 90,6% in the group receiving 10-day scheme and 93.6% in the group receiving the 14-day treatment. Conclusion. Significant deviations of clinical practice from expert recommendations, most pronounced at the stage of monitoring the effectiveness of therapy, were noted. The suboptimal efficacy of triple therapy is shown.


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.


2019 ◽  
Vol 91 (2) ◽  
pp. 16-24 ◽  
Author(s):  
D S Bordin ◽  
Yu V Embutnieks ◽  
L G Vologzhanina ◽  
T A Ilchishina ◽  
I N Voynovan ◽  
...  

The multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group (EHMSG) is conducted in 27 countries in Europe. The data from the Russian part of the European registry for the management of Helicobacter pylori infection (European Registry on the management of Helicobacter pylori infection, protocol: “Hp-EuReg”) allows us to analyze the real clinical practice of diagnosis and treatment of H. pylori and compare it with international recommendations. Materials and methods. A comparative analysis of the data entered in the register by the Russian research centers “Hp-EuReg”, in the period from 2013 to 2018, was conducted. Results and discussion. Invasive diagnostic methods prevail for the primary diagnosis of H. pylori [histology - 20.3% (in 2013 year) - 43.9% (in 2018 year), rapid urease test - 31.7% and 47.8% respectively]. The most popular mode of eradication therapy is a 10-day triple therapy (62.8-76.2%), the effectiveness of which does not exceed 79% (per protocol). Invasive tests (histology) are the leading method for control the effectiveness of therapy, however, there is a tendency towards a wider use of non-invasive methods (H. pylori stool antigen - from 17% in 2013 to 29.3% in 2018 and urea breath test from 6.9 to 18.3%, respectively). Serological test to control the effectiveness of eradication is still used from 8.2% (2013) to 6.1% (2018). Eradication therapy was not performed in 28% of patients throughout the entire observation period. Conclusion. In Russia, despite approved domestic and international recommendations, deviations in clinical practice persist, both during eradication therapy and in monitoring the effectiveness of eradication therapy.


2011 ◽  
Vol 51 (184) ◽  
Author(s):  
H H Jeon ◽  
HH Jeon

The relationship between gastroesophageal refl ux disease (GERD) and Helicobacter pylori (H. pylori) eradication is still debated. Recently, we had a patient of GERD who had developed it shortly after H. pylori eradication therapy. A 72-year-old man was diagnosed by endoscopy as suffering from severe superfi cial gastritis in the stomach body. A rapid urease test showed H. pylori infection. He was then started on proton pump inhibitor (PPI) based therapy for two weeks eradicating H.pylori. After completion of H. pylori eradication, he complained of a heart-burn sensation. Follow-up endoscopy showed refl ux esophagitis, of grade B according to the Los Angeles classifi cation. Since the patient had developed GERD after completion of the triple therapy, their suggests that H. pylori eradication must have triggered the development of de novo GERD after a short period of time. Keywords: GERD, Helicobacter pylori, PPI.


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.


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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