Newer agents for Helicobacter pylori eradication

Fiorini, Giulia; Zullo, Angelo; Gatta, Luigi; Castelli, Vincenzo Parenti; Ricci, Chiara; Cassol, Francesca; Vaira, Dino

doi:10.2147/ceg.s25422

Cited by 9 publications

(5 citation statements)

References 37 publications

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“…pylori infection is generally acquired in childhood, and it persists throughout life. Spontaneous resolution is rare, and a targeted therapy is needed [9]. The specificity for H. pylori culture, in our study, was 90.90%, but the sensitivity was low,…”

Section: Discussioncontrasting

confidence: 58%

A Study of the Correlation between Bacterial Culture and Histological Examination in Children with Helicobacter pylori Gastritis

Galoș¹,

Năstase²,

Boboc³

et al. 2019

Histology

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Helicobacter pylori (H. pylori) is one of the most common chronic bacterial infections in the world, and it is currently estimated that approximately half of the world's population is infected with the bacterium. The correct diagnosis and effective treatment of H. pylori gastric infection are essential in controlling this condition. The available diagnostic methods have advantages and limitations related to factors such as age of patients, technical difficulty level, costs and extensive accessibility in hospitals. The eradication therapy of H. pylori infection is still a challenge for gastroenterologists. One of the main causes of failure in H. pylori eradication is antibiotic resistance. Biopsy cultures are the most widely used methods among the antimicrobial susceptibility tests. In case of a negative culture, H. pylori can be clearly recognised in histological sections. The sensitivity and specificity of histology for the diagnosis depend on clinical settings, density of colonisation and the experience of the histopathologist. A prospective study was performed in order to analyse patients with H. pylori gastric infection with positive histology and positive culture versus positive histology and negative culture.

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Section: Discussioncontrasting

confidence: 58%

A Study of the Correlation between Bacterial Culture and Histological Examination in Children with Helicobacter pylori Gastritis

Galoș¹,

Năstase²,

Boboc³

et al. 2019

Histology

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“…Despite the fact that its prevalence is decreasing, H. pylori is still a widespread infection causing benign and malignant diseases [1]. Unfortunately, no therapy regimen achieves bacterial eradication in all patients, the treatment for the infection remaining challenging [2]. Current Italian guidelines suggested the use of either 14day triple therapy or 10-day sequential therapy for first-line therapy [3].…”

Section: Introductionmentioning

confidence: 99%

Sequential Therapy for First-Line Helicobacter pylori Eradication: 10- or 14-Day Regimen?

Zullo

Fiorini

Scaccianoce

et al. 2019

JGLD

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Background & Aim: Standard 10-day sequential therapy is advised as first-line therapy for Helicobacter pylori (H. pylori) eradication by current Italian guidelines. Some data suggested that a 14-day regimen may achieve higher eradication rates. This study compared the efficacy of sequential therapy administered for either 10- or 14-days.Methods: This prospective, multicenter, open-label study enrolled patients with H. pylori infection without previous treatment. Patients were receiving a sequential therapy for either 10 or 14 days with esomeprazole 40 mg and amoxicillin 1 g (5 or 7 days) followed by esomeprazole 40 mg, clarithromycin 500 mg and tinidazole 500 mg (5 or 7 days), all given twice daily. Bacterial eradication was checked using 13C-urea breath test. Eradication cure rates were calculated at both Intention-to-treat (ITT) and per-protocol (PP) analyses.Results: A total of 291 patients were enrolled, including 146 patients in 10-day and 145 in the 14-day regimen. The eradication rates were 87% (95% CI = 81.5-92.4) and 90.3% (95% CI = 85.5-95.1) at ITT analysis with the 10- and 14-day regimen, respectively, and 92.7% (95% CI = 88.3-97) and 97% (95% CI = 94.2-99.9) at PP analysis (p =0.37). Among patients, who earlier had interrupted therapy, bacterial eradication was achieved in 8 out of 9 who completed the first therapy phase and performed at least ≥3 days of triple therapy in the second phase.Conclusion: This study found that both 10- and 14-day sequential therapies achieved a high eradication rate for first-line H. pylori therapy in clinical practice.

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“…During the last decade, the efficacy of standard 7-14-day triple therapies decreased to approximately 70% in many areas, mainly due to increasing primary bacterial resistance to antibiotics. [ 16 17 ]…”

Section: Introductionmentioning

confidence: 99%

N-acetyl cysteine as an adjunct to standard anti-Helicobacter pylori eradication regimen in patients with dyspepsia: A prospective randomized, open-label trial

Zobeiri¹,

Rahimi

Arjomandi

et al. 2014

Adv Biomed Res

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Background:Increasing antibiotic resistance of Helicobacter pylori (H. pylori) which is associated with diseases of the upper gastrointestinal tract, has made alternative treatments necessary. This study compares the efficacy of adding N-acetyl cysteine (NAC) to standard regimen for H. pylori eradication.Materials and Methods:We conducted a randomized, open-label trial, comparing the efficacy of 14 days of quadruple therapy with Amoxicillin, Bismuth citrate, Omeprazole, Clarithromycin (group A) versus 14 days of above regimen plus NAC (group B) in adult patients with dyspepsia. Primary objective was H. pylori eradication. Compliance and side effects were determined by questionnaires. Our analysis was by intention-to-treat (ITT) and per-protocol. This study is registered with www.IRCT.ir, number: IRCT201201078634N1.Result:A total of 121 participants aged 21-76 years with a mean age of 44.5 ± 14.1, and 52.9% female, were randomly allocated a treatment: 60 with 14-day standard therapy and 61 with 14-day standard therapy with NAC. The eradication rate in groups A and B with ITT analyses was 49/60 (81.7%; 95% [confidence intervals] CI = 71.6-91.8%) and 50/61 (82%; 95% CI = 72-91.9%), respectively (P = 0.96). In per-protocol analysis, the rate of H. pylori eradication in groups A and B was 45/54 (83.3%; 95% CI = 73.1-93.6%) and 45/53 (84.9%; 95% CI = 74.9-94.9%), respectively (P = 0.82). Minor well tolerated side effects were reported in 15 (34.9%) and 21 (35.6%) patients of groups A and B, respectively, and only one therapy cessation in group A was created.Conclusion:Standard 14-day triple-drug therapy with NAC is not preferable to standard drug regimens for H. pylori infection.

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Newer agents for Helicobacter pylori eradication

Cited by 9 publications

References 37 publications

A Study of the Correlation between Bacterial Culture and Histological Examination in Children with Helicobacter pylori Gastritis

A Study of the Correlation between Bacterial Culture and Histological Examination in Children with Helicobacter pylori Gastritis

Sequential Therapy for First-Line Helicobacter pylori Eradication: 10- or 14-Day Regimen?

N-acetyl cysteine as an adjunct to standard anti-Helicobacter pylori eradication regimen in patients with dyspepsia: A prospective randomized, open-label trial

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