Helicobacter pylori Infection: An Update for the Internist in the Age of Increasing Global Antibiotic Resistance

Siddique, Osama; Ovalle, Anais; Siddique, Ayesha; Moss, Steven F.

doi:10.1016/j.amjmed.2017.12.024

Cited by 48 publications

(35 citation statements)

References 49 publications

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“…With the increasing prevalence of antibiotic resistance, the eradication of H pylori becomes more and more difficult. 16 In addition to this issue, several studies also noted the importance of the consensus on the management of H pylori infection. 9,10,17 There is sufficient evidence that explicit guidelines do improve clinical practice when introduced in the context of rigorous evaluations.…”

Section: Discussionmentioning

confidence: 99%

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Management of Helicobacter pylori infection by clinicians: A nationwide survey in a developing country

et al. 2019

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Background & Aims Developing countries are making efforts to improve health management. Practice deviating from the guideline means inefficient control. The study aims to investigate the management of Helicobacter pylori (H pylori) infection from a developing country perspective. Methods An authoritative survey was conducted in 14th (2014) and 17th (2017) Congress of Gastroenterology China, respectively. The Maastricht V/Florence consensus report was invoked as the evaluation criterion. Results A total of 4182 valid samples were included in this study. Most of the respondents (94%) updated knowledge by lectures. Respondents had a different awareness rate of H pylori‐related diseases, ranging from 45% to 95%. Up to 40% of the respondents did not follow the recommendations for the diagnosis. Choice accuracy of eradication regimens and antibiotic combinations was <70%. About 20% of the respondents did not pay attention to the confirmation after the eradication. The situation had been improved in 2017 when compared with that in 2014 (all P < .05). Multivariate logistic regression analysis revealed that influencing factors including nongastroenterologists, bachelor degree and below, the primary professional title, hospital location, and a small proportion of H pylori infection in daily practice related to the deviation of consensus (all P < .05). Conclusions Although the management of H pylori infection has been improved in a developing country, there is still a gap between the real‐world practices and the consensus. Influencing factors should be taken into account in decision‐making, and the corresponding population should be strengthened with precision training during the promotion of the guideline.

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Section: Discussionmentioning

confidence: 99%

“…Unfortunately, there were discrepancies between the consensus and the real-world practice of clinicians. 16,20,21 H pylori infection leads to peptic ulcer in 15%-20% of the infected population, 22 dyspepsias in 5%-10%…”

Section: Discussionmentioning

confidence: 99%

Management of Helicobacter pylori infection by clinicians: A nationwide survey in a developing country

et al. 2019

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“…HP is one of the most common causes of bacterial infections in human (22). H. pylori infection is generally transmitted in childhood by Table 1.…”

Section: Discussionmentioning

confidence: 99%

An experimental in-vitro study to evaluate the anti-helicobacter activity of Glycyrrhetinic acid

Çelik

Duran

2019

Revista Romana De Medicina De Laborator

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Aim: The aim of this study was to investigate the in-vitro efficacy of Glycyrrhetinic acid against Helicobacter pylori (H. pylori) strains, as compared with conventional antibacterial agents. Methods: A total of 41 H. pylori isolates were used, 6 of which were of standard strains (NCTC 1637), 8 of which were drug-sensitive, and 27 were resistant to drugs isolates. Clarithromycin and metronidazole resistance in all strains of H. pylori were determined by the Epsilometer test (E-test) method. MIC study was performed by using microdilution broth method. Results: Glycyrrhetinic acid was found to be effective against H. pylori NCTC 1637 in doses of 12.0±4.38 µg/mL, while the MIC value of clinical H. pylori isolates susceptible to antimicrobials was 20.8±10.11 µg/ml. It was found that the MIC values for antimicrobial-sensitive clinical H. pylori isolates was higher when compared with H. pylori NCTC 1637 strains. The MIC values of the standard antimicrobial agents against drug-resistant H. pylori strains were higher than H. pylori NCTC 1637 strains and drug-sensitive H. pylori strains. The MIC value was found to be 14.22±7.77 µg/ml for metronidazole, 3.89±1.90 µg/ml for clarithromycin, 2.33±1.0 µg/ml for amoxicillin, 2.44±0.88 µg/ml for levofloxacin and 4.89±2.47 µg/ml for tetracycline, whereas the MIC value of Glycyrrhetinic acid was 26.67±8.0 µg/ml in metronidazole-resistant H. pylori isolates. Besides, MIC values of the antimicrobials and 18ß-Glycyrrhetinic acid among the strains resistant to clarithromycin were as follows: 3.25±2.12 µg/ml for metronidazole, 9.71±4.54 µg/ml for clarithromycin, 2.06±1.32 µg/ml for amoxicillin, 3.88±4.22 µg/ml for levofloaxacin and 3.25±1.04 µg/mL for tetracycline and 22.0±11.11 µg/ml for Glycyrrhetinic acid. Conclusion: Glycyrrhetinic acid had significant antimicrobial activity against H. pylori strains. Although further in-vivo studies are needed on antimicrobial activity of Glycyrrhetinic acid, increased resistance to drugs currently used in treatment suggests that Glycyrrhetinic acid may be a potential agent for the treatment of H. pylori.

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“…Our recent data published in 2017 shows that rate of CAM-resistant strains in HD patients is 40.5% of infected patients[ 55 ]. Alternative regimens may be designed to use H. pylori- susceptible antimicrobial agents, increased dosages of antimicrobial agents and PPIs, increased dosing frequency, and longer treatment periods, according to international treatment guidelines[ 13 , 52 , 56 - 60 ].…”

Section: Necessity Of H Pylori Eradication Therapmentioning

confidence: 99%

Nutrition status andHelicobacter pyloriinfection in patients receiving hemodialysis

Sugimoto

Yasuda

Andoh

2018

WJG

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Chronic kidney disease (CKD) patients receiving hemodialysis (HD) often develop gastrointestinal abnormalities over their long treatment period. In general, prognosis in such patients is poor due to the development of protein-energy wasting (PEW). Therefore, it is important to clarify the etiology of PEW and to establish better strategies to deal with this condition. Chronic Helicobacter pylori (H. pylori) infection in the gastric mucosa has a close association with not only the development of peptic ulcer disease and gastric cancer, but is also associated with abnormal plasma and gastric mucosal ghrelin levels that are seen in malnutrition. It is unclear whether H. pylori infection of the gastric mucosa is directly associated with prognosis in HD patients by affecting ghrelin levels. Recent studies show that the prevalence of H. pylori infection in HD patients is significantly lower than in subjects with normal renal function. In the natural history of H. pylori infection in HD patients, the prevalence of infection decreases as the length of time on HD increases. The severity of gastric mucosal atrophy has been suggested as the major determinant of ghrelin levels in these patients, and eradication therapy of H. pylori improves nutritional status by increasing serum cholinesterase and cholesterol levels, especially in patients with mild-to-moderate gastric mucosal atrophy. Prompt H. pylori eradication to inhibit the progress of gastric atrophy may be required to prevent this decrease in ghrelin levels and subsequent PEW and improve the prognosis of HD patients by improving their nutritional status.

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Helicobacter pylori Infection: An Update for the Internist in the Age of Increasing Global Antibiotic Resistance

Cited by 48 publications

References 49 publications

Management of Helicobacter pylori infection by clinicians: A nationwide survey in a developing country

Management of Helicobacter pylori infection by clinicians: A nationwide survey in a developing country

An experimental in-vitro study to evaluate the anti-helicobacter activity of Glycyrrhetinic acid

Nutrition status andHelicobacter pyloriinfection in patients receiving hemodialysis

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