Meta-analysis: Is combination of tetracycline and amoxicillin suitable for<i>Helicobacter pylori</i>infection?

Lv, Zhifa; Wang, Fucai; Zheng, Huilie; Wang, Ben; Xie, Yong; Zhou, Xiaojiang; Lv, Nonghua

doi:10.3748/wjg.v21.i8.2522

Cited by 26 publications

(22 citation statements)

References 67 publications

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“…Six studies exclusively evaluated second-line treatment for patients with at least one prior course of treatment failure [ 27 – 32 ]; 12 studies focused on treatment naive patients [ 25 , 26 , 33 – 42 ]; the remaining systematic reviews included RCTs for both first-line and second-line treatment. 13 studies evaluated treatments in patients with comorbid gastric diseases including peptic ulcer disease, duodenal ulcer, functional dyspepsia, chronic gastritis or other non-ulcer diseases [ 24 , 27 , 37 – 40 , 43 – 49 ] (the remaining studies did not provide such data). In addition to the eradication rate, 15 systematic reviews also compared adverse events rates [ 25 , 28 – 38 , 41 , 47 , 50 ] and six compared the discontinuity rate (compliance rate) [ 25 , 29 – 31 , 37 , 50 ].…”

Section: Resultsmentioning

confidence: 99%

Pharmacological regimens for eradication of Helicobacter pylori: an overview of systematic reviews and network meta-analysis

et al. 2016

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BackgroundApproximately half of the world’s population is infected with Helicobacter pylori (H.pylori), a bacterium shown to be linked with a series of gastrointestinal diseases. A growing number of systematic reviews (SRs) have been published comparing the effectiveness of different treatments for H.pylori infection but have not reached a consistent conclusion. The objective of this study is to provide an overview of SRs of pharmacological therapies for the eradication of H.pylori.MethodsMajor electronic databases were searched to identify relevant SRs published between 2002 and February 2016. Studies were considered eligible if they included RCTs comparing different pharmacological regimens for treating patients diagnosed as H.pylori infected and pooled the eradication rates in a meta-analysis. A modified version of the ‘A Measurement Tool to Assess Systematic Reviews’ (AMSTAR) was used to assess the methodological quality. A Bayesian random effects network meta-analysis (NMA) was conducted to compare the different proton pump inhibitors (PPI) within triple therapy.Results30 SRs with pairwise meta-analysis were included. In triple therapy, the NMA ranked the esomeprazole to be the most effective PPI, followed by rabeprazole, while no difference was observed among the three old generations of PPI for the eradication of H.pylori. When comparing triple and bismuth-based therapy, the relative effectiveness appeared to be dependent on the choice of antibiotics within the triple therapy; moxifloxacin or levofloxacin-based triple therapy were both associated with greater effectiveness than bismuth-based therapy as a second-line treatment, while bismuth-based therapy achieved similar or greater eradication rate compared to clarithromycin-based therapy. Inconsistent findings were reported regarding the use of levofloxacin/moxifloxacin in the first-line treatment; this could be due to the varied resistant rate to different antibiotics across regions and populations. Critical appraisal showed a low-moderate level of overall methodological quality of included studies.ConclusionsOur analysis suggests that the new generation of PPIs and use of moxifloxacin or levofloxacin within triple therapy as second-line treatment were associated with greater effectiveness. Given the varied antibiotic resistant rate across regions, the appropriateness of pooling results together in meta-analysis should be carefully considered and the recommendation of the choice of antibiotics should be localized.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-016-0491-7) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Pharmacological regimens for eradication of Helicobacter pylori: an overview of systematic reviews and network meta-analysis

et al. 2016

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“…In the Fourth Chinese National Consensus , we recommended five therapy regimens, including classical bismuth‐containing quadruple therapy . Since then, we further extended two regimens of bismuth‐containing quadruple therapy (PPI + bismuth + amoxicillin + metronidazole, PPI + bismuth + amoxicillin + tetracycline) . The composition of these regimens, drug dosages, and usage is shown in Table .…”

Section: Treatmentmentioning

confidence: 99%

Fifth Chinese National Consensus Report on the management ofHelicobacter pyloriinfection

et al. 2018

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“…Each of them has its own antibacterial spectrum and advantages. Amoxicillin trihydrate, a common treatment for peptic or gastric ulcers caused by H. pylori infection, 186 loaded in κ-carrageenan hydrogels containing CaCO 3 and NaHCO 3 or CS/polygamma-glutamic acid nanoparticle pH-sensitive hydrogels was well protected from the gastric juice, thus facilitating drug effects specifically at the site of infection. 187,188 The similar results of in vivo studies by Moogooee et al 189 showed that the amoxicillin-loaded hydrogels enhance drug concentration at the topical site than powder amoxicillin, meaning that therapeutic concentration can be achieved at a much lower dose which may reduce the adverse effects of amoxicillin in high doses.…”

Section: Other Antibioticsmentioning

confidence: 99%

Antimicrobial hydrogels: promising materials for medical application

Yang

Han

Chen

et al. 2018

IJN

302

230

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The rapid emergence of antibiotic resistance in pathogenic microbes is becoming an imminent global public health problem. Local application of antibiotics might be a solution. In local application, materials need to act as the drug delivery system. The drug delivery system should be biodegradable and prolonged antibacterial effect should be provided to satisfy clinical demand. Hydrogel is a promising material for local antibacterial application. Hydrogel refers to a kind of biomaterial synthesized by a water-soluble natural polymer or a synthesized polymer, which turns into gel according to the change in different signals such as temperature, ionic strength, pH, ultraviolet exposure etc. Because of its high hydrophilicity, unique three-dimensional network, fine biocompatibility and cell adhesion, hydrogel is one of the suitable biomaterials for drug delivery in antimicrobial areas. In this review, studies from the past 5 years were reviewed, and several types of antimicrobial hydrogels according to different ingredients, different preparations, different antimicrobial mechanisms, different antimicrobial agents they contained and different applications, were summarized. The hydrogels loaded with metal nanoparticles as a potential method to solve antibiotic resistance were highlighted. Finally, future prospects of development and application of antimicrobial hydrogels are suggested.

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Meta-analysis: Is combination of tetracycline and amoxicillin suitable forHelicobacter pyloriinfection?

Abstract: The effectiveness of regimens employing amoxicillin and tetracycline for H. pylori eradication may be not inferior to other regimens, but further study should be necessary.

Cited by 26 publications

References 67 publications

Pharmacological regimens for eradication of Helicobacter pylori: an overview of systematic reviews and network meta-analysis

Pharmacological regimens for eradication of Helicobacter pylori: an overview of systematic reviews and network meta-analysis

Fifth Chinese National Consensus Report on the management ofHelicobacter pyloriinfection

Antimicrobial hydrogels: promising materials for medical application

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