Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option

Eisig, Jaime Natan; Silva, Fernando Marcuz; Barbuti, Ricardo Correa; Navarro–Rodriguez, Tomás; Moraes-Filho, Joaquim Prado P; Pedrazzoli, José

doi:10.1590/s0004-28032011000400008

Cited by 45 publications

(49 citation statements)

References 26 publications

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“…Its effectiveness basically depends on rates of resistance to clarithromycin and is not recommended in areas where these rates among the population are higher than 20%. The few Brazilian studies on clarithromycin resistance show rates below this value (45,78,123,160) . While not outstanding, in the last 10 years this regimen has shown eradication rates close to 80% among us (29,54,134,166) .…”

Section: Statement 27mentioning

confidence: 94%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

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Section: Statement 27mentioning

confidence: 94%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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“…A study by Mégraud [62] of more than 2000 patients with H. pylori infection showed resistance rates of 14.1% for levofloxacin, with significantly higher fluoroquinolone resistance in Western/Southern Europe than in Northern Europe [62] . O'Connor et al [63] reported that 11.7% of patients had strains resistant to levofloxacin in Ireland and there was a 29.1% resistance rate in 2011 in Germany [64] , 15% in Senegal [44] and 23% in Brazil [65] .…”

Section: Current Antibiotic Resistance In Worldwidementioning

confidence: 99%

Antibiotic treatment forHelicobacter pylori: Is the end coming?

Kim

Choi

Chung

2015

WJGPT

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Infection with the Gram-negative pathogen Helicobacter pylori (H. pylori ) has been associated with gastroduodenal disease and the importance of H. pylori eradication is underscored by its designation as a group I carcinogen. The standard triple therapy consists of a proton pump inhibitor, amoxicillin and clarithromycin, although many other regimens are used, including quadruple, sequential and concomitant therapy regimens supplemented with metronidazole, clarithromycin and levofloxacin. Despite these efforts, current therapeutic regimens lack efficacy in eradication due to antibiotic resistance, drug compliance and antibiotic degradation by the acidic stomach environment. Core tip: This article reviews the recent literature describing antibiotic resistance and trends in Helicobacter pylori (H. pylori ) treatment. As there is no effective conventional therapy, new treatments are being developed and bismuth quadruple, sequential, concomitant therapies are recommended as a first-line regimen in regions with high levels of clarithromycin resistance. Quinolones have also been used for H. pylori treatment, although the cure rate has gradually reduced with this approach. New therapeutic directions include probiotic supplementation, tailored therapy, novel agents, and nanotechnology.

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“…There was no observed resistance to amoxicillin, tetracycline or Furazolidone [7]. In 2013 another Brazilian study was done to search for the H .pylori antibiotic resistance in children and adolescents.…”

Section: Introductionmentioning

confidence: 99%

“…This drug present low bacterial resistance and it is effective against the strains of H. pylori and have a reduced cost [2,[7][8][9]. In 2002, Eisig et al [7] proposed a 7-day treatment based on furazolidone and tetracycline combined to a pump inhibitor (Omeprazole) in patients that had been previously treated. Not so good rates of eradication were observed (75% by protocol and 69% with intention-to-treat), with many side effects which impeded the continued use of these medications [10].…”

Section: Introductionmentioning

confidence: 99%

Helicobacter Pylori Treatment with Alternative Drugs: Good and Cheap for Developing Countries Furazolidone-Based Treatment- Omeprazole, Furazolidone and Tetracycline Open-Label Trial in A Developing Country: Why Not?

Rizzuto¹,

Pasqualucci²,

Chehter³

2014

GHOA

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a. Past or present duodenal and/or gastric ulcer, with or without complications. b. Following resection of gastric cancer. AbstractObjective: To analyze eradication rate and evaluate collateral effects of an existing alternative dosage, comprised of Omeprazole, tetracycline and furazolidone for 7 days in patients with gastric and/or duodenal ulcers and first-degree relatives of family members with a diagnosis of gastric cancer with positive study for Helicobacter pylori (H. pylori) and treatment-naive. Design and location:The out patients from the Clinic of the Gastroenterology Department of the ABC Medical School, Santo Andre, SP-Brazil. Results: 85 patients were included in the study of which 55 completed the treatment. 95% of the patients had an adequate adherence to the treatment. 49% of the patients analyzed by protocol had at least one side effect, with the most common being nausea (24%) and there was no statistical difference between the relation of side effects and lapse of treatment for H. pylori. 5% (3 patients) interrupted the treatment. The eradication rate per protocol (PP) was 96% (95%CI: 84% to 100%) for patients who completed the treatment. Patients and methods: Conclusion:The therapy based on Omeprazole, tetracycline and furazolidone in the dosages proposed represents a good and low-cost alternative to the first-line therapy to eradicate infection by H. pylori in treatment-naive patients in a developing country.

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Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option

Cited by 45 publications

References 26 publications

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Antibiotic treatment forHelicobacter pylori: Is the end coming?

Helicobacter Pylori Treatment with Alternative Drugs: Good and Cheap for Developing Countries Furazolidone-Based Treatment- Omeprazole, Furazolidone and Tetracycline Open-Label Trial in A Developing Country: Why Not?

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