Eradication of Helicobacter Pylori with Triple Therapy Comprising Probiotic & Proton Pump Inhibitor

Objectives: The current clinical trial compared the effects of conventional triple therapy and probiotic (Lactobacillus reuteri) plus omeprazole combination in peptic ulcer patients. The secondary objectives included estimating the effects of these regimens on safety and tolerability. Study Design: Randomized clinical trial Abode and Period of Study: This was a six month research study conducted at the National Medical Centre, Karachi, Pakistan in October 2020 – March 2021. Materials & Methods: A total of 100 patients were recruited, had baseline positive stool antigen test. All the participants were separated into dual groups: conventional triple remedy (group A1) and probiotic with omeprazole combination (group B1). The study's primary endpoint was stool antigen assay and secondary included change in Hb, LFTs and renal function test. Results: The primary endpoints for combination therapy led to significantly greater reductions in positive stool antigen assay than triple therapy. This means that combination therapy is far better than triple therapy. The stool antigen test showed 56.5% positive and 43.5% negative in group A1 while in group B1 34.8% positive while 65.2% negative after treatment were seen with statistically significant difference (p=0.036). Insignificant findings were observed for level of Hb, LFTs and renal function test between both groups during the entire study. Conclusion: This is the first randomized clinical trial in peptic ulcer patients of Pakistan treated with probiotic plus omeprazole combination. Combination therapy was generally well-tolerated and effective in eradicating the Helicobacter pylori after initiation of therapy.

Download Full-text

European registry on Helicobacter pylori management (Hp-EuReg) as a tool to evaluate and improve clinical practice in Moscow

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.02.000567 ◽

2020 ◽

Vol 92 (2) ◽

pp. 12-18

Author(s):

D. S. Bordin ◽

I. N. Voynovan ◽

Yu. V. Embutnieks ◽

O. P. Nyssen ◽

Francis Megraud ◽

...

Keyword(s):

Helicobacter Pylori ◽

Clinical Practice ◽

Proton Pump Inhibitor ◽

Triple Therapy ◽

Proton Pump ◽

Antigen Test ◽

Stool Antigen Test ◽

Standard Triple Therapy ◽

Stool Antigen ◽

H Pylori

Continuous evaluation of the actual clinical practice of diagnosis and treatment of Helicobacter pylori is crucial in order to provide the best standard of care and to compare health outcomes with expert recommendations. Aim:to evaluate the effectiveness of the standard triple therapy (amoxicillin, clarithromycin, a proton pump inhibitor) and the standard triple therapy plus bismuth tripotassium dicitrate. Materials and methods.Observational, prospective, multicenter study, carried out in one single Russian centre A.S. Loginov Moscow Clinical Scientific Center as part of the Hp-EuReg. Patients were included from 2013 to November 2019 by Russian gastroenterologists. Results.A total of 647 patients were collected and 330 were administered either standard triple therapy ((amoxicillin, clarithromycin, a proton pump inhibitor) or standard triple therapy plus bismuth tripotassium dicitrate. Invasive methods is dominates in the initial diagnosis of H. pylori: the frequency of use of the quick urease test decreased from 50% in 2013 to 31% in 2019. Serology was used in 27.9%. There has been an increase in the use of the13C-urea breath test from 13% in 2013 to 31% in 2019. The histological method (7.5%) and the stool antigen test (3.2%) were used less frequently. For eradication control non-invasive methods are mostly used:13C-UDT (82.7%) and the stool antigen test (14.4%). The effectiveness of standard triple therapy (mITT) was 68% with a 7-day course, 79% with a 10-day course, and 70% with a 14-day course. Combination of bismuth and standard triple therapy eradicates H. pylori (mITT) in 63%, 75% and 89%, respectively. Conclusion.An improvement in the clinical practice of managing patients with H. pylori infections has been noted. The standard triple therapy in combination with bismuth tripotassium dicitrate, prescribed for 14 days, is more effective.

Download Full-text

Characteristics of Helicobacter pylori-seropositive subjects according to the stool antigen test findings: a prospective study

The Korean Journal of Internal Medicine ◽

10.3904/kjim.2016.353 ◽

2018 ◽

Vol 33 (5) ◽

pp. 893-901

Author(s):

Hee-Won Moon ◽

Sun-Young Lee ◽

Mina Hur ◽

Yeo-Min Yun

Keyword(s):

Helicobacter Pylori ◽

Prospective Study ◽

Antigen Test ◽

Stool Antigen Test ◽

Stool Antigen ◽

A Prospective Study

Download Full-text

Evaluation of a Newly Developed Rapid Stool Antigen Test Using an Immunochromatographic Assay To Detect Helicobacter pylori

Japanese Journal of Infectious Diseases ◽

10.7883/yoken.66.60 ◽

2013 ◽

Vol 66 (1) ◽

pp. 60-64 ◽

Cited By ~ 7

Author(s):

Dong Wook Jekarl ◽

Yeon Ju An ◽

Seungok Lee ◽

Jehoon Lee ◽

Yonggoo Kim ◽

...

Keyword(s):

Helicobacter Pylori ◽

Immunochromatographic Assay ◽

Antigen Test ◽

Stool Antigen Test ◽

Stool Antigen

Download Full-text

Applicability of a rapid stool antigen test, using monoclonal antibody to catalase, for the management of Helicobacter pylori infection

Journal of Gastroenterology ◽

10.1007/s00535-011-0371-4 ◽

2011 ◽

Vol 46 (4) ◽

pp. 487-491 ◽

Cited By ~ 17

Author(s):

Tadashi Shimoyama ◽

Manabu Sawaya ◽

Atsushi Ishiguro ◽

Norihiro Hanabata ◽

Tetsuro Yoshimura ◽

...

Keyword(s):

Monoclonal Antibody ◽

Helicobacter Pylori ◽

Helicobacter Pylori Infection ◽

Antigen Test ◽

Stool Antigen Test ◽

Stool Antigen

Download Full-text

The Utility of the helicobacter pylori stool antigen test in managing dyspepsia: an experience from a low resource setting

African Health Sciences ◽

10.4314/ahs.v14i4.9 ◽

2015 ◽

Vol 14 (4) ◽

pp. 829 ◽

Cited By ~ 5

Author(s):

IL Segamwenge ◽

M Kagimu ◽

P Ocama ◽

K Opio

Keyword(s):

Helicobacter Pylori ◽

Antigen Test ◽

Stool Antigen Test ◽

Low Resource ◽

Resource Setting ◽

Low Resource Setting ◽

Stool Antigen

Download Full-text

Results of an open-label, randomized, comparative clinical trial of nifuratel in the eradication of Helicobacter pylori infection in adult patients

Clinical Microbiology and Antimicrobial Chemotherapy ◽

10.36488/cmac.2020.2.119-127 ◽

2020 ◽

Vol 22 (2) ◽

pp. 119-127

Author(s):

Natalya N. Dekhnich ◽

A.A. Tryapyshko ◽

Ivan V. Trushin ◽

Alexey Yu. Kuzmenkov ◽

Roman S. Kozlov

Keyword(s):

Clinical Trial ◽

Triple Therapy ◽

Adult Patients ◽

Study Group ◽

Open Label ◽

Comparative Clinical Trial ◽

Stool Antigen Test ◽

Comparator Group ◽

H Pylori ◽

Intent To Treat

Objective. To assess efficacy and safety of 14-day triple nifuratel-based therapy compared to 14-day standard triple therapy in adult patients with symptomatic H. pylori infection. Materials and Methods. A total of 70 patients with dyspepsia and microbiologically confirmed H. pylori infection were enrolled into the open-label, randomized, comparative clinical trial. The study group (n = 35) received a 14-day triple nifuratel-based therapy: esomeprazole (20 mg BID), nifuratel (400 mg BID) and amoxicillin (1000 mg BID). The comparator group (n = 35) received 14-day conventional clarithromycinbased triple therapy: esomeprazole (20 mg BID), clarithromycin (500 mg BID) and amoxicillin (1000 mg BID). Eradication of H. pylori was assessed using stool antigen test. Results. Eradication rates for 14-day nifuratel-based triple therapy and 14-day clarithromycin-based triple therapy in the intent-to-treat (ITT) population were 82.9% and 74.3% (p = 0.561), respectively. In the per-protocol (PP) population, eradication rates were 90.6% and 89.7% (p = 1.00), respectively. Adverse events were reported in 17.1% of patients in the study group and 34.3% of patients in the comparator group (p > 0.05). Conclusions. The 14-day triple nifuratel-based therapy has demonstrated a high H. pylori eradication rate (above 90%). Nifuratel triple therapy may be considered as an alternative to clarithromycin-based triple therapy for patients with a history of the prior macrolide exposure or macrolide intolerance.

Download Full-text