Spiramycin is comparable to oxytetracycline in eradicating <i>H. pylori</i> when given with ranitidine bismuth citrate and metronidazole

Ólafsson, Snorri; Berstad, Arnold; Cj, Bang; G, Nysaeter; Coll, Peter; Tefera, Solomon; Jg, Hatlebakk; Hausken, Trygve; T, Olafsson

doi:10.1046/j.1365-2036.1999.00517.x

Cited by 13 publications

(7 citation statements)

References 15 publications

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“…in the course of 10‐day triple therapies including metronidazole and either bismuth subnitrate or ranitidine bismuth citrate. Eradication rates were 89–91%, 18 , 19 comparable to those previously obtained with similar treatment regimens employing tetracycline, with the advantage of a lower incidence of side‐effects.…”

Section: Macrolidessupporting

confidence: 76%

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Alternative antibacterial agents for Helicobacter pylori eradication

Guslandi

2001

Aliment Pharmacol Ther

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Standard eradication therapies against Helicobacter pylori appear to be effective in most cases, but in clinical practice a failure rate higher than the 5–10% reported in clinical trials is often observed. Among the various reasons responsible for therapeutic failure, antibiotic resistance is becoming a major issue in some countries. A range of different antibacterial agents is currently under investigation: several macrolides, new fluoroquinolones, furazolidone and rifabutin. Although not formally tested in refractory cases, azithromycin, spiromycin, levofloxacin and furazolidone represent the most promising antibacterial agents for possible inclusion in eradication regimens. Rifabutin has been evaluated in H. pylori infections resistant to standard therapies. Although very effective, the drug is expensive and its use should be restricted to the most difficult cases to avoid the development of rifabutin resistance in Mycobacterium spp.

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Section: Macrolidessupporting

confidence: 76%

“…Spiramycin is a well‐tolerated macrolide, which was tested first in a small pilot study, 18 and then in a large trial, 19 both from Norway. The drug was given at a dose of 500–1000 mg q.d.s.…”

Section: Macrolidesmentioning

confidence: 99%

Alternative antibacterial agents for Helicobacter pylori eradication

Guslandi

2001

Aliment Pharmacol Ther

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“…These triple therapies, when compared with quadruple therapies, have the advantage of generating less adverse events. When a high level of metronidazole resistance is suspected, it can be replaced by furazolidone 83 ,. 84 …”

Section: Recommended Regimens For Refractory Helicobacter Pylori Infementioning

confidence: 99%

Review article: the treatment of refractory Helicobacter pylori infection

Mégraud¹,

Lamouliatte

2003

Aliment Pharmacol Ther

188

172

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SUMMARYThe occurrence of refractory Helicobacter pylori infection is increasing. When the bacteria are not eradicated it means that the antibiotics have not reached the gastric mucosa at a sufficient concentration and over a sufficient time lapse to kill them. The main reasons for this are poor patient compliance, resistant bacteria, low gastric pH and a high bacterial load. Therefore, when administering a new treatment, it is important to choose antibiotics which do not face resistance problems and which increase the dosage of antisecretory drugs and the duration of treatment and, if possible, to add a topical agent such as bismuth salt.The recommended empirical strategy is to prescribe quadruple therapy or, alternatively, 2-week triple therapy including amoxicillin-metronidazole, tetracycline-metronidazole or amoxicillin-rifabutin. However,

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“…Hence, the use of azithroymcin is not recommended. Spiramycin is the only macrolide, other than clarithromycin, that can be recommended for treatment of H. pylori infection [41][42][43].…”

Section: Other Macrolidesmentioning

confidence: 99%

Clarithromycin for Helicobacter pylori infection

Leung

Graham

2000

Expert Opinion on Pharmacotherapy

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Helicobacter pylori, a Gram-negative organism that survives in the deep mucus layer and attaches to the gastric surface cells, is estimated to be present in up to one-half of the US population. Chronic H. pylori infection causes chronic gastritis, peptic ulcer diseases and even gastric cancer. Cure of the infection leads to healing of gastric inflammation, prevention of development of peptic ulcer, as well as accelerated healing of peptic ulcers, and prevention of ulcer recurrence. Treatment of H. pylori has undergone substantial evolution over the past decade. Despite the in vitro susceptibility, results from single or even dual drug therapy is typically unsatisfactory and the best therapy is yet to be defined. The best current therapies for H. pylori infection consist of a proton pump inhibitor (PPI) or ranitidine bismuth citrate and two antibiotics (triple therapies), or bismuth, tetracycline, metronidazole and a PPI (quadruple therapy). Clarithromycin is one of the most useful antimicrobials against H. pylori. It is an acid-stable macrolide with a broad spectrum of antibacterial activity, well absorbed with a wide tissue distribution and with mild side effects. Clarithromycin has a low minimum inhibitory concentration (MIC50) for H. pylori and its effect is potentiated by acid inhibition. When combined with a PPI or ranitidine bismuth citrate and amoxicillin or metronidazole, eradication rates of more than 95% can be achieved with susceptible organisms. However, the prevalence of primary and acquired clarithromycin resistance, which is due to mutations within a conserved loop of 23S rRNA of H. pylori, is increasing. In practice, the presence of clarithromycin resistance usually implies reduced success when clarithromycin-containing regimes are used. There is a need for improved therapies for H. pylori where antibiotic resistance is less of a problem.

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Spiramycin is comparable to oxytetracycline in eradicating H. pylori when given with ranitidine bismuth citrate and metronidazole

Cited by 13 publications

References 15 publications

Alternative antibacterial agents for Helicobacter pylori eradication

Alternative antibacterial agents for Helicobacter pylori eradication

Review article: the treatment of refractory Helicobacter pylori infection

Clarithromycin for Helicobacter pylori infection

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