Challenges to the Treatment and New Perspectives for the Eradication of Helicobacter pylori

Yazbek, Priscila Baptistella; Trindade, Ariane Biolcati; Chin, Chung Man; Santos, Jean Leandro dos

doi:10.1007/s10620-015-3712-y

Cited by 17 publications

(10 citation statements)

References 115 publications

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“…6 Poor treatment adherence is secondary to several factors, mainly complex treatment regimens requiring multiple daily doses of different drugs and adverse effects of antimicrobial drugs. 10 The most F I G U R E 1 Flowchart illustrating the cases included in the study common GI side effects associated with antibiotic therapy include diarrhea, nausea, vomiting, bloating, and abdominal pain that may affect the treatment adherence, 11 with subsequent risk of therapeutic failure and development of antibiotic resistance.…”

Section: Discussionmentioning

confidence: 99%

Bismuth‐containing quadruple therapy versus concomitant quadruple therapy as first‐line treatment for Helicobacter Pylori infection in an area of high resistance to clarithromycin: A prospective, cross‐sectional, comparative, open trial

et al. 2018

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Background Concomitant quadruple (CQT) or bismuth‐containing quadruple therapy (BQT) is recommended as first‐line treatment for Helicobacter pylori infection depending on antibiotic resistance. Aim To compare the efficacy, safety, and compliance of CQT and BQT as first‐line therapy for H. pylori eradication in real clinical practice in an area of high resistance to clarithromycin. Methods A prospective, open, comparative cross‐sectional study including dyspeptic patients >18 years with H. pylori infection and with no previous eradication treatment was performed. CQT (omeprazole 20 mg + clarithromycin 500 mg + amoxicillin 1 g + metronidazole 500 mg, all given twice daily, for 14 days) or BQT (omeprazole 20 mg twice daily + 3 capsules of Pylera® 4 times a day, for 10 days) was prescribed at the discretion of the prescribing physician. Eradication was tested by 13C‐urea breath test. Efficacy was assessed by intention‐to‐treat (ITT) and per‐protocol (PP) analyses. Results One hundred and four consecutive patients were included (64.4% female, age 52.9 years). Fifty patients received CQT and 54 BQT. Eradication rate was similar with both therapies at the PP (CQT 97.9%, 95% CI: 93.9‐100 vs BQT 96.2%, 95% CI: 90.9‐100, P = 0.605) and ITT analyses (CQT 98.0%, 95% CI: 94‐100 vs BQT 94.4%, 95% CI: 88.1‐100, P = 0.346). The rate of adverse events was also similar with CQT (56%) and BQT (46.3%). One patient in each group discontinued the treatment due to significant adverse events. Conclusion The use of CQT and BQT as first‐line treatment against H. pylori is similarly effective and safe strategy in an area of high clarithromycin resistance.

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Section: Discussionmentioning

confidence: 99%

Bismuth‐containing quadruple therapy versus concomitant quadruple therapy as first‐line treatment for Helicobacter Pylori infection in an area of high resistance to clarithromycin: A prospective, cross‐sectional, comparative, open trial

et al. 2018

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“…Treatment of H. pylori in people currently consists of multiple drugs, either simultaneously or sequentially, and PPIs are almost always an integral component of treatment . Infected dogs and cats almost always have non‐ H. pylori Helicobacter (NHPH) that appears to have different pathophysiologic effects and different responses to treatment compared to H. pylori .…”

Section: Evidence To Support Clinical Use Of Gastroprotectants In Dogmentioning

confidence: 99%

ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats

Marks

Kook

Papich

et al. 2018

Veterinary Internal Medicne

177

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The gastrointestinal (GI) mucosal barrier is continuously exposed to noxious toxins, reactive oxygen species, microbes, and drugs, leading to the development of inflammatory, erosive, and ultimately ulcerative lesions. This report offers a consensus opinion on the rational administration of GI protectants to dogs and cats, with an emphasis on proton pump inhibitors (PPIs), histamine type‐2 receptor antagonists (H2RAs), misoprostol, and sucralfate. These medications decrease gastric acidity or promote mucosal protective mechanisms, transforming the management of dyspepsia, peptic ulceration, and gastroesophageal reflux disease. In contrast to guidelines that have been established in people for the optimal treatment of gastroduodenal ulcers and gastroesophageal reflux disease, effective clinical dosages of antisecretory drugs have not been well established in the dog and cat to date. Similar to the situation in human medicine, practice of inappropriate prescription of acid suppressants is also commonplace in veterinary medicine. This report challenges the dogma and clinical practice of administering GI protectants for the routine management of gastritis, pancreatitis, hepatic disease, and renal disease in dogs and cats lacking additional risk factors for ulceration or concerns for GI bleeding. Judicious use of acid suppressants is warranted considering recent studies that have documented adverse effects of long‐term supplementation of PPIs in people and animals.

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“…While the cases of H. pylori have been decreasing over the last decade due to improved cleanliness and eradication therapy, the rate of PUD has not decreased dramatically in some countries. This leads us to conclude that the usage of NSAIDs and aspirin in the elderly, then, is the reason why PUD is still common [12][13][14].…”

Section: Introductionmentioning

confidence: 96%

The effect of statins on the occurrence of peptic ulcer

Feng

Chuang

Wu³

et al. 2015

European Journal of Internal Medicine

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Challenges to the Treatment and New Perspectives for the Eradication of Helicobacter pylori

Cited by 17 publications

References 115 publications

Bismuth‐containing quadruple therapy versus concomitant quadruple therapy as first‐line treatment for Helicobacter Pylori infection in an area of high resistance to clarithromycin: A prospective, cross‐sectional, comparative, open trial

Bismuth‐containing quadruple therapy versus concomitant quadruple therapy as first‐line treatment for Helicobacter Pylori infection in an area of high resistance to clarithromycin: A prospective, cross‐sectional, comparative, open trial

ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats

The effect of statins on the occurrence of peptic ulcer

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