Clarithromycin-Resistant Helicobacter pylori in Patients With Duodenal Ulcer in the United States

Vakil, Nimish; Hahn, Beth; McSorley, David

doi:10.1111/j.1572-0241.1998.455_t.x

Cited by 117 publications

(96 citation statements)

References 14 publications

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“…Resistant strains of H. pylori are now widely prevalent in the west, and the eradication rate with current regimens fails in 10% to 20% of patients [Vakil et al 1998;Mégraud et al 2013].…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus reuteri in management of Helicobacter pylori infection in dyspeptic patients: a double-blind placebo-controlled randomized clinical trial

Emara

Mohamed

Abdel-Aziz

2013

Therap Adv Gastroenterol

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Introduction: The eradication rate of Helicobacter pylori following the standard triple therapy is declining. This study was conducted to test whether the addition of Lactobacillus reuteri to the standard triple therapy improves the eradication rates as well as the clinical and pathological aspects in H. pylori infection. Methods: A total of 70 treatment-naïve patients were randomly assigned into group A (the L. reuteri treated group) and group B (the placebo control group). Patients were treated by the standard triple therapy for 2 weeks and either L. reuteri or placebo for 4 weeks. They were examined by symptom questionnaire, H. pylori antigen in stool, upper endoscopy with biopsies for rapid urease test and histopathological examination before treatment and 4 weeks after treatment. Results: The eradication rate of H. pylori infection was 74.3% and 65.7% for both L. reuteri and placebo treated groups, respectively. There was a significant difference regarding the reported side effects, where patients treated with L. reuteri reported less diarrhea and taste disorders than placebo group. A significant difference within each group was observed after treatment regarding Gastrointestinal Symptom Rating Scale (GSRS) scores; patients treated with L. reuteri showed more improvement of gastrointestinal symptoms than the placebo treated group. The severity and activity of H. pylori associated gastritis were reduced after 4 weeks of therapy in both groups. The L. reuteri treated group showed significant improvement compared with the placebo treated group. Conclusion: Triple therapy of H. pylori supplemented with L. reuteri increased eradication rate by 8.6%, improved the GSRS score, reduced the reported side effects and improved the histological features of H. pylori infection when compared with placebo-supplemented triple therapy.

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“…Resistant strains of H. pylori are now widely prevalent in the west, and the eradication rate with current regimens fails in 10% to 20% of patients [Vakil et al 1998;Mégraud et al 2013].…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus reuteri in management of Helicobacter pylori infection in dyspeptic patients: a double-blind placebo-controlled randomized clinical trial

Emara

Mohamed

Abdel-Aziz

2013

Therap Adv Gastroenterol

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“…Eradication therapy consists of antibiotics combined with proton pump inhibitors and is particularly suitable for patients with severe symptoms. However, many patients discontinue such treatment following the appearance of various types of adverse reactions, or emergence of antibiotic resistant strains (8,22), which deteriorate H. pylori chronic infection status. Therefore, it is important to determine the effect of therapeutic vaccination on animal model with chronic H. pylori infection which is closer to the actual situation in human.…”

Section: Discussionmentioning

confidence: 99%

“…Eradication of colonizing H. pylori by antimicrobial agents markedly reduces clinical manifestations; however, emergence of strains resistant to clarithromycin or metronidazole, as well as various types of adverse reactions due to multiple combinations of antibiotics often hamper the expected beneficial effects of such treatment (8,22). On the other hand, oral or parenteral immunization using H. pylori whole cell sonicate (WCS) or a recombinant urease seem to be effective in preventing subsequent H. pylori infection, as demonstrated in a series of studies seeking an alternative to antibiotic therapy.…”

mentioning

confidence: 99%

Evaluation of Therapeutic Efficacy of Adjuvant Helicobacter pylori Whole Cell Sonicate in Mice with Chronic H. pylori Infection

Maeda

Yamashiro

Minoura

et al. 2002

Microbiology and Immunology

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“…Moreover, during the last few years, the efficacy of PPIbased regimens seems to be decreasing, and several studies have reported intention-to-treat eradication rates lower than 75% [Paoluzi et al 2006;Calvet et al 2005;Gisbert et al 2005b;Vakil et al 2004;Hawkey et al 2003;Veldhuyzen Van Zanten et al 2003;Laine et al 2000Laine et al , 1998] and even lower than 50% [Altintas et al 2004;Gumurdulu et al 2004;Della Monica et al 2002]. Antibiotic resistance to clarithromycin has been identified as one of the major factors affecting our ability to cure H. pylori infection, and the rate of resistance to this antibiotic seems to be increasing in many geographical areas [Egan et al 2008;Megraud, 2004;Vakil et al 1998]. …”

Section: Introductionmentioning

confidence: 99%

Review: Second-line rescue therapy of Helicobacter pylori infection

Gisbert

2009

Therap Adv Gastroenterol

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Helicobacter pylori infection is the main known cause of gastritis, gastroduodenal ulcer disease and gastric cancer. After more than 20 years of experience in H. pylori treatment, however, the ideal regimen to treat this infection has still to be found. Nowadays, apart from having to know well first-line eradication regimens, we must also be prepared to face treatment failures. Therefore, in designing a treatment strategy we should not focus on the results of primary therapy alone, but also on the final (overall) eradication rate. The choice of a 'rescue' treatment depends on which treatment is used initially. If a first-line clarithromycin-based regimen was used, a second-line metronidazole-based treatment (quadruple therapy) may be used afterwards, and then a levofloxacin-based combination would be a third-line 'rescue' option. Alternatively, it has recently been suggested that levofloxacin-based 'rescue' therapy constitutes an encouraging second-line strategy, representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure, with the advantage of efficacy, simplicity and safety. In this case, quadruple regimen may be reserved as a third-line 'rescue' option. Finally, rifabutin-based 'rescue' therapy constitutes an encouraging empirical fourth-line strategy after multiple previous eradication failures with key antibiotics such as amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin. Even after two consecutive failures, several studies have demonstrated that H. pylori eradication can finally be achieved in almost all patients if several 'rescue' therapies are consecutively given. Therefore, the attitude in H. pylori eradication therapy failure, even after two or more unsuccessful attempts, should be to fight and not to surrender.

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Clarithromycin-Resistant Helicobacter pylori in Patients With Duodenal Ulcer in the United States

Cited by 117 publications

References 14 publications

Lactobacillus reuteri in management of Helicobacter pylori infection in dyspeptic patients: a double-blind placebo-controlled randomized clinical trial

Lactobacillus reuteri in management of Helicobacter pylori infection in dyspeptic patients: a double-blind placebo-controlled randomized clinical trial

Evaluation of Therapeutic Efficacy of Adjuvant Helicobacter pylori Whole Cell Sonicate in Mice with Chronic H. pylori Infection

Review: Second-line rescue therapy of Helicobacter pylori infection

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