Antimicrobial Susceptibility‐Guided Therapy Versus Empirical Concomitant Therapy for Eradication of <i>Helicobacter pylori</i> in a Region with High Rate of Clarithromycin Resistance

Cosme, Ángel; Lizasoan, Jacobo; Montes, Milagrosa; Tamayo, Esther; Alonso, Horacio; Mendarte, Usua; Martos, Maider; Fernández‐Reyes, María José; Saraqueta, Cristina; Bujanda, Luís

doi:10.1111/hel.12231

Cited by 46 publications

(43 citation statements)

References 23 publications

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“…Better results with susceptibility-guided triple therapy than with empirical concomitant therapy were obtained in a region of high clarithromycin resistance 278. Bismuth-containing quadruple therapy is the least dependent treatment on antibiotic resistance.…”

Section: Working Group 3: Treatmentmentioning

confidence: 99%

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

Malfertheiner

Mégraud

O’Moráin

et al. 2016

Gut

2,434

3,052

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Section: Working Group 3: Treatmentmentioning

confidence: 99%

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

Malfertheiner

Mégraud

O’Moráin

et al. 2016

Gut

2,434

3,052

View full text Add to dashboard Cite

“…Therefore, surveillance and antimicrobial susceptibility for all commonly used antibiotics facilitates effective therapy[7]. To optimize an eradication therapy for H. pylori , maximize the treatment efficacy, and prevent prolonged treatment, routine susceptibility testing can aid the prescription of appropriate antibiotic regimens prior to treatment for H. pylori in geographic areas with a high prevalence of resistant strains[84]. …”

Section: Contribution Of Antimicrobial Susceptibility Testing To the mentioning

confidence: 99%

“…The eradication rates of susceptibility-guided treatments are generally higher than those of empirical treatment regimens[7,81,86]. Recent studies have also shown that susceptibility-based treatment improves the efficacy of the therapy used after first- or second-line treatment failure as well as the efficacy of first-line therapy (Tables 1 and 2)[26,73,82-84,87-92]. A meta-analysis of five randomized controlled trials concluded that the culture-based pretreatment success rates were 16% higher than those of various standard triple therapies used as the first-line treatment for H. pylori infection in 701 patients (per protocol 93% vs 76%)[6,9,82].…”

Section: Contribution Of Antimicrobial Susceptibility Testing To the mentioning

confidence: 99%

Importance of antimicrobial susceptibility testing for the management of eradication inHelicobacter pyloriinfection

Arslan

Yılmaz

Demiray-Gürbüz

2017

WJG

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The management of Helicobacter pylori (H. pylori) infection treatment differs from the common treatment protocol for other infectious diseases. Because culture- or molecular-guided approaches face several practical issues, such as the invasive procedures required to obtain gastric biopsy specimens and the lack of availability of routine laboratory testing in some places, H. pylori treatment includes the administration of two or three empirically selected antibiotics combined with a proton pump inhibitor rather than evidence-based eradication treatment. The efficacy of empirical therapy is decreasing, mostly due to increasing multiple resistance. Multiresistance to levofloxacin, clarithromycin, and metronidazole, which are commonly used in empirical treatments, appears to have increased in many countries. Mutations play a primary role in the antimicrobial resistance of H. pylori, but many different mechanisms can be involved in the development of antibiotic resistance. Determining and understanding these possible mechanisms might allow the development of new methods for the detection of H. pylori and the determination of antimicrobial resistance. A treatment based on the detection of antimicrobial resistance is usually more effective than empirical treatment. Nevertheless, such an approach before treatment is still not recommended in the Maastricht guidelines due to the difficulty associated with the routine application of available culture- or molecular-based susceptibility tests, which are usually administered in cases of treatment failure. The management of first and rescue treatments requires further research due to the steadily increase in antimicrobial resistance.

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“…Gastroscopy will have to be performed and biopsies obtained for H. pylori culture. (44,45) It is important that treatment compliance is explored with these patients and any barriers to compliance are addressed.…”

Section: Failure Of Second-line Treatmentmentioning

confidence: 99%

The diagnosis and management of H. pylori infection in Singapore

Chew

Lye²,

Ang

2017

smedj

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Antimicrobial Susceptibility‐Guided Therapy Versus Empirical Concomitant Therapy for Eradication of Helicobacter pylori in a Region with High Rate of Clarithromycin Resistance

Abstract: For HP eradication in a region with high rates of multiple drug resistance, antimicrobial susceptibility-guided therapy is more effective than empirical concomitant therapy.

Cited by 46 publications

References 23 publications

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

Importance of antimicrobial susceptibility testing for the management of eradication inHelicobacter pyloriinfection

The diagnosis and management of H. pylori infection in Singapore

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