Role of antibiotic sensitivity testing before first‐line Helicobacter pylori eradication treatments

Neri, Matteo; Milano, Angelo; Laterza, Francesco; Bonaventura, Giovanni Di; Piccolomini, R; Caldarella, M.P.; Balatsinou, Chrysanthi; Lapenna, Domenico; Cuccurullo, Franco

doi:10.1046/j.1365-2036.2003.01757.x

Cited by 42 publications

(45 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Figure 1 details the procedure of study selection in the flow chart. Thirteen studies [13][14][15][16][17][18][19][20][21][22][23][24][25] were qualified in this meta-analysis. Tables 1 and 2 set 2 different control groups, respectively, which were labeled as group a and b in our study (e.g., Lee a and Lee b).…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Ten tailored regimens [14][15][16][17]19,[21][22][23][24][25] were designed according to pretreatment susceptibility testing (pooled RR ¼ 1.17, 95% CI 1.11-1.24). Three other studies 13,18,20 advanced their susceptibility-guided therapy by additionally adjusting their PPI administration (either by dosage adjustments or by changing drugs) on the basis of CYP2C19 polymorphism (pooled RR ¼ 1.14, 95% CI 1.01-1.28).…”

Section: Types Of Tailored Regimensmentioning

confidence: 99%

See 1 more Smart Citation

318 Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication: A Meta-Analysis

Chen¹,

Dang²,

Zhou³

et al. 2016

Gastroenterology

View full text Add to dashboard Cite

Section: Statistical Analysesmentioning

confidence: 99%

Section: Types Of Tailored Regimensmentioning

confidence: 99%

318 Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication: A Meta-Analysis

Chen¹,

Dang²,

Zhou³

et al. 2016

Gastroenterology

View full text Add to dashboard Cite

“…Pretreatment susceptibility testing was shown to be cost saving and associated with higher eradication rates (21); other data question the use of prior susceptibility testing before the use of first-and second-line therapies (16,18). These conflicting results are probably due to the different study settings and the different patients evaluated.…”

Section: Fig 2 Proportions Ofmentioning

confidence: 99%

Quinolone Resistance in Helicobacter pylori Isolates in Germany

Glocker

Stueger

Kist

2007

Antimicrob Agents Chemother

View full text Add to dashboard Cite

We show that quinolone resistance in Helicobacter pylori has reached an alarming level in Germany. Our data suggest that the use of quinolones requires prior antimicrobial susceptibility testing, especially for isolates from patients who have already undergone previous unsuccessful eradication treatments, and also underline the further need for surveillance studies to monitor antibiotic resistance in H. pylori.Helicobacter pylori infection causes gastritis and can result in complications such as peptic ulcer diseases, mucosa-associated lymphoid tissue lymphoma, or gastric cancer (22). In Germany, antibiotic chemotherapy that includes amoxicillin, clarithromycin, and a proton pump inhibitor is recommended for the eradication of these bacteria in infected individuals (14). After treatment failures, quinolone-based triple therapies have been shown to be highly effective and therefore have been proposed as rescue regimens (4,20).The aim of this study was to estimate the prevalence of quinolone resistance in H. pylori by testing the antimicrobial susceptibilities of clinical isolates obtained between 2001 and 2005. We analyzed H. pylori isolates from patients who had already been treated (n ϭ 805; 86%) or who had not been treated (n ϭ 126; 14%). Susceptibilities to ciprofloxacin, metronidazole, and clarithromycin were determined by the Etest method, according to the manufacturer's instructions and a modified protocol, as described previously (9). Isolates were classified as resistant to ciprofloxacin and clarithromycin when the MIC was Ͼ1 mg/liter and were classified as resistant to metronidazole when the MIC was Ͼ8 mg/liter (9, 12).Due to the predominance of previously treated patients, the overall rates of resistance to metronidazole (Mtz r ; 67.8%), clarithromycin (Cla r ; 62.9%), and to both antimicrobials (Mtz r Cla r ; 39.8%) were expectedly high. We also observed a large number (n ϭ 150; 16.1%) of ciprofloxacin-resistant isolates; detailed analysis showed that the majority of these isolates (n ϭ 95; 10.2%) were also resistant to metronidazole and clarithromycin, whereas only a minority (n ϭ 17; 1.8%) were exclusively resistant to ciprofloxacin.Previous unsuccessful eradication trials appear to be an important risk factor for the development of overall quinolone resistance and triple-drug resistance, since those patterns of resistance were more common among isolates from previously treated patients (Cip r , 17.1%; Mtz r Cla r Cip r , 11.8%) than among those derived from previously untreated individuals (Cip r , 9.5%; Mtz r Cla r Cip r , 0.0%). A chi-square test confirmed these differences to be significant at an error level of 5% (Fig. 1). Next, we also analyzed the average MICs of ciprofloxacin and compared the annual differences in the proportions of quinolone-resistant isolates.The (Fig. 2). Logistic regression analysis showed a significant positive trend for the proportions of Cip r isolates and Mtz r Cla r Cip r isolates. Similar high rates of quinolone resistance were reported from Korea (12) and Italy (...

show abstract

“…Of the six potential eligible articles, we excluded another one which focused on second-line treatment for H. pylori infection (39). Five RCTs (n=701 patients) were included at last (28)(29)(30)(31)(32). The quality of the included studies is shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Accumulating evidences [included randomized controlled trials (RCTs)] suggest antibiotic sensitivity testing results in improving eradication rate (26)(27)(28)(29)(30)(31). Nevertheless, the effects still remain controversial (32)(33)(34). Furthermore, whether or not culture-guided therapy is cost saving is another bone of contention, compared to standard treatment (30,31,35,36 (38) …”

Section: Introductionmentioning

confidence: 99%

Is Antimicrobial Susceptibility Testing Necessary Before First-line Treatment for Helicobacter pylori Infection? -Meta-analysis of Randomized Controlled Trials-

Wang

Guan

et al. 2010

Intern. Med.

View full text Add to dashboard Cite

was used as a measure of the effect of two regimens mentioned above with a fixed-effects model using the methods of DerSimonian and Laird. Results Five randomized controlled trials totaling 701 patients were included. The meta-analysis showed that culture-guided triple therapy was superior referring to a higher eradication rate from intention-to-treat analyses (RR, 0.84; 95% CI,0.77, 0.90; p<0.00001) and a lower overall cost. Conclusion Culture-guided triple therapy was more effective than standard triple therapy for first-line treatment of Helicobacter pylori infection. Based on the only paper focused on the overall cost, the cultureguided triple therapy was also more cost saving. Antimicrobial susceptibility testing is necessary before firstline treatment for Helicobacter pylori infection.

show abstract

Role of antibiotic sensitivity testing before first‐line Helicobacter pylori eradication treatments

Cited by 42 publications

References 61 publications

318 Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication: A Meta-Analysis

318 Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication: A Meta-Analysis

Quinolone Resistance in Helicobacter pylori Isolates in Germany

Is Antimicrobial Susceptibility Testing Necessary Before First-line Treatment for Helicobacter pylori Infection? -Meta-analysis of Randomized Controlled Trials-

Contact Info

Product

Resources

About