IV Conferencia Española de Consenso sobre el tratamiento de la infección por Helicobacter pylori

Gisbert, Javier P.; Molina–Infante, Javier; Amador, Javier; Bermejo, Fernando; Bujanda, Luís; Calvet, Xavier; Castro‐Fernández, Manuel; Cuadrado‐Lavín, Antonio; Elizalde, J. Ignasi; Gené, Emili; Gomollón, Fernando; Lanas, Fernando; Argila, Carlos Martín de; Mearin, Fermı́n; Montoro, Miguel; Pérez-Aísa, Ángeles; Pérez-Trallero, Emilio; McNicholl, Adrián G.

doi:10.1016/j.gastrohep.2016.05.003

Cited by 97 publications

(42 citation statements)

References 192 publications

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“…A number of strategies have been recommended to potentially overcome dual H. pylori -resistance (clarithromycin and metronidazole) including longer duration of quadruple therapies (concomitant-14 d, bismuth -14 d), higher dose of new-generations - PPIs (esomeprazole or rabeprazole), hybrid therapy (a 7 d of PPI plus amoxicillin, followed by 7 d of PPI, amoxicillin, clarithromycin and metronidazole) or quadruple therapy with levofloxacin and bismuth - 14 d (PPI regime plus amoxicillin, bismuth and levofloxacin)[13-16]. Quadruple sequential therapy (14 d), hybrid therapy and non-bismuth quadruple concomitant therapy (14 d) are expected to fail if the rate of dual clarithromycin and metronidazole resistant strains are > 5%, > 9%, and > 15%, respectively[7].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial susceptibility testing before first-line treatment for Helicobacter pylori infection in patients with dual or triple antibiotic resistance

Cosme

Montes

Ibarra

et al. 2017

WJG

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AIMTo evaluate the efficacy of antimicrobial susceptibility-guided therapy before first-line treatment for infection in patients with dual or triple antibiotic resistance.METHODSA total of 1034 patients infected by Helicobacter pylori (H. pylori) during 2013-2014 were tested for antimicrobial susceptibility. 157 of 1034 (15%) patients showed resistance to two (127/1034; 12%) and to three (30/1034; 3%) antibiotics. Sixty-eight patients with dual H. pylori-resistance (clarithromycin, metronidazole or levofloxacin) were treated for 10 d with triple therapies: OAL (omeprazole 20 mg b.i.d., amoxicillin 1 g b.i.d., and levofloxacin 500 mg b.i.d.) 43 cases, OAM (omeprazole 20 mg b.i.d., amoxicillin 1 g b.i.d., and metronidazole 500 mg b.i.d.) 12 cases and OAC (omeprazole 20 mg b.id., amoxicillin 1 g b.i.d., and clarithromycin 500 mg b.i.d.) 13 cases based on the antimicrobial susceptibility testing. Twelve patients showed triple H. pylori-resistance (clarithromycin, metronidazole and levofloxacin) and received for 10 d triple therapy with OAR (omeprazole 20 mg b.id., amoxicillin 1 g b.i.d., and rifabutin 150 mg b.i.d.). Eradication was confirmed by 13C-urea breath test. Adverse effects and compliance were assessed by a questionnaire.RESULTSIntention-to-treat eradication rates were: OAL (97.6%), OAM (91.6%), OAC (92.3%) and OAR (58.3%). Cure rate was significantly higher in naïve patients treated with OAR-10 compared to patients who had two or three previous treatment failures (83% vs 33%). Adverse events rates for OAL, OAM, OAC and OAR were 22%, 25%, 23% and 17%, respectively, all of them mild-moderate.CONCLUSIONAntimicrobial susceptibility-guided triple therapies during 10 d for first-line treatment leads to an eradication rate superior to 90% in patients with dual antibiotic H. pylori resistance.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial susceptibility testing before first-line treatment for Helicobacter pylori infection in patients with dual or triple antibiotic resistance

Cosme

Montes

Ibarra

et al. 2017

WJG

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“…While more than half responded 'No' to this question, 40.4% state that they have had some problem with the water, on a range of 2-4. Helicobacter pylori infects approximately 50% of the Spanish population [31,32].…”

Section: Spaniards' Perception Of Water Usementioning

confidence: 99%

Citizen and Educational Initiatives to Support Sustainable Development Goal 6: Clean Water and Sanitation for All

2020

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Sustainable Development Goal 6 affirms the need to “ensure water availability, sustainable water management and sanitation for all” and thereby highlights a current problem in Spain caused by climate dynamics in the south and southeast of the peninsula and the islands. This study is based on a non-probabilistic online survey with 455 participants (n = 455) carried out to identify citizens’ views across the Autonomous Communities and detect good and bad practices, including efficiency gains and specific problems, derived from water management. Differences in perceptions were found regarding place of residence, gender, and education level, which were all especially significant in relation to territory. Generally, people who live in areas with greater water abundance are less aware of the need to make good use of it. There are no major differences in terms of gender, although there is a greater awareness among women about the effects of climate change and the need for good water management. It is argued that education should employ innovative materials and pedagogically motivating resources from school to university levels.

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“…Therefore, the recommendation for using a 14-day triple therapy in the updated Italian guidelines would appear at least questionable. For instance, based on the disappointing results of national studies [27], the Spanish guidelines wisely excluded 14-day triple therapies from the recommended treatments [14]. In contrast, in Latin America [28], the cure rate following the 14-day clarithromycin–amoxicillin triple therapy (82.2%) was higher than that of either concomitant (73.6%) or sequential (76.5%) therapies, most probably because of the very high (>80%) prevalence of metronidazole resistance in the H. pylori strains.…”

Section: Clarithromycin-based Triple Therapiesmentioning

confidence: 99%

“…Specifically, we considered European [8], NICE [12], Italian [13], Spanish [14] American [9] and Canadian [15] guidelines for Western countries, and Asian [16], Australian [17], Japanese [18], and Chinese [19] guidelines for Eastern countries.…”

Section: Introductionmentioning

confidence: 99%

First-line therapies for Helicobacter pylori eradication: a critical reappraisal of updated guidelines

Francesco¹,

Bellesia²,

Manta

et al. 2017

aog

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Helicobacter pylori (H. pylori) treatment remains a challenge for the clinician, as no available therapy is able to cure the infection in all treated patients. In the last two decades, several antibiotic combinations have been proposed, including triple therapies, bismuth-free therapies (sequential, concomitant, hybrid regimens), and bismuth-based quadruple therapy. Some national and international guidelines on H. pylori management have recently been updated, recommending or discouraging the use of each of these therapeutic approaches, based mainly on the presumed pattern of primary antibiotic resistance in different geographic areas. We examined the recommendations on first-line therapies in the most recently updated guidelines worldwide, taking into account other data affecting the efficacy of a therapy regimen beyond the primary resistance pattern. Although several guidelines highlighted that the results achieved by an eradication therapy are population-specific and not directly transferable, it emerged that some therapy regimens are recommended or discouraged with no mention of the vital need for national data.

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IV Conferencia Española de Consenso sobre el tratamiento de la infección por Helicobacter pylori

Cited by 97 publications

References 192 publications

Antimicrobial susceptibility testing before first-line treatment for Helicobacter pylori infection in patients with dual or triple antibiotic resistance

Antimicrobial susceptibility testing before first-line treatment for Helicobacter pylori infection in patients with dual or triple antibiotic resistance

Citizen and Educational Initiatives to Support Sustainable Development Goal 6: Clean Water and Sanitation for All

First-line therapies for Helicobacter pylori eradication: a critical reappraisal of updated guidelines

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