Ten day sequential versus 10 day modified bismuth quadruple therapy as empirical firstline and secondline treatment for<i>Helicobacter pylori</i>in Chinese patients: an open label, randomised, crossover trial

Liu, Kevin S H; Hung, Ivan Fan-Ngai; Seto, Wai Kay; Tong, Teresa; Hsu, Axel; Lam, Frank Y.F.; But, David; Wong, Siu–Yin; Leung, Wai K.

doi:10.1136/gutjnl-2013-306120

Cited by 45 publications

(23 citation statements)

References 29 publications

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“…Moxifloxacin triple therapy has been recently reported to achieve a 67% eradication rate as second-line treatment after first-line bismuth quadruple failure in 28 patients in Korea 249. In a study from China, bismuth therapy was effective as first-line treatment in 99% of patients, and in the two patients who failed, sequential therapy was effective 250. Using a clarithromycin-containing treatment as second-line therapy after failure of a BQT does not seem to be practical since bismuth therapies are usually proposed as first-line treatments for areas of high clarithromycin resistance.…”

Section: Working Group 3: Treatmentmentioning

confidence: 99%

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

Malfertheiner

Mégraud

O’Moráin

et al. 2016

Gut

2,444

3,052

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Section: Working Group 3: Treatmentmentioning

confidence: 99%

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

Malfertheiner

Mégraud

O’Moráin

et al. 2016

Gut

2,444

3,052

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“…For example, the ITT eradication rate with modified bismuth quadruple therapy was 92.7% in a recent randomized study in Chinese patients [79] . A pilot study in United States Hispanics showed that 14-d bismuth quadruple anti-H. pylori therapy achieved a > 95% eradication rate [80] .…”

Section: Publication Treatment Duration Patients Therapy Regimen Eradmentioning

confidence: 99%

Antibiotic treatment forHelicobacter pylori: Is the end coming?

Kim

Choi

Chung

2015

WJGPT

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Infection with the Gram-negative pathogen Helicobacter pylori (H. pylori ) has been associated with gastroduodenal disease and the importance of H. pylori eradication is underscored by its designation as a group I carcinogen. The standard triple therapy consists of a proton pump inhibitor, amoxicillin and clarithromycin, although many other regimens are used, including quadruple, sequential and concomitant therapy regimens supplemented with metronidazole, clarithromycin and levofloxacin. Despite these efforts, current therapeutic regimens lack efficacy in eradication due to antibiotic resistance, drug compliance and antibiotic degradation by the acidic stomach environment. Core tip: This article reviews the recent literature describing antibiotic resistance and trends in Helicobacter pylori (H. pylori ) treatment. As there is no effective conventional therapy, new treatments are being developed and bismuth quadruple, sequential, concomitant therapies are recommended as a first-line regimen in regions with high levels of clarithromycin resistance. Quinolones have also been used for H. pylori treatment, although the cure rate has gradually reduced with this approach. New therapeutic directions include probiotic supplementation, tailored therapy, novel agents, and nanotechnology.

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“…2. "Alternative eradication regimens" included prescription of a PPI in combination with two or more different antibiotics of which at least one was from the following groups (excluding the antibiotics used for recommended eradication): macrolides (J01FA), imidazole derivatives (J01XD), tetracyclines (J01AA), fluoroquinolones (J01MA), nitrofuran derivatives (J01XE) or rifabutin (J04AB04), possibly in combination with bismuth subcitrate (A02BX05) [5,10,11]. To exclude antibiotic combination treatment for indications other than H. pylori eradication, we excluded prescription episodes including antibiotics with a dosage for >21 days [based on the defined daily dosage (DDD) per package] and individuals who received 50 prescriptions for antibiotics during the study period, since these were unlikely to be prescribed for H. pylori eradication.…”

Section: Definition Of Eradication Regimensmentioning

confidence: 99%

Helicobacter pylori eradication in the Swedish population

Doorakkers

Lagergren

Gajulapuri

et al. 2017

Scandinavian Journal of Gastroenterology

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Objectives: Helicobacter pylori is associated with peptic ulcers and gastric cancer and its eradication aims to prevent these conditions. The recommended eradication regimen is triple therapy, consisting of a proton-pump inhibitor in combination with clarithromycin and amoxicillin or metronidazole for 7 days. Yet, other antibiotic regimens are sometimes prescribed. We aimed to assess the use of eradication therapy for H. pylori in the Swedish population during the last decade. Materials and methods: This population-based study used data from the Swedish Prescribed Drug Register. From July 2005 until December 2014, all regimens that can eradicate H. pylori were identified and evaluated according to patients' age and sex and calendar year of eradication. Results: We identified 157,915 eradication episodes in 140,391 individuals (53.8% women, 42.6% older than 60 years), who correspond to 1.5% of the Swedish population. The absolute number and incidence of eradications decreased over the study period. Overall, 91.0% had one eradication and 0.1% had more than three. Of all eradications, 95.4% followed the recommended regimen, while 4.7% did not. The latter group was overrepresented among individuals aged 80 years (7.8%). Amoxicillin and clarithromycin were most frequently prescribed, while metronidazole was rarely used (0.01%). Other prescribed antibiotics were ciprofloxacin (2.4%), doxycycline (1.4%), nitrofurantoin (0.7%), norfloxacin (0.5%) and erythromycin (0.3%). Conclusions: During the last decade in Sweden H. pylori eradication has been frequently prescribed, but the incidence of eradication has slowly declined. Most eradications followed the recommended regimen, including those occurring after a previous eradication. ARTICLE HISTORY

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Ten day sequential versus 10 day modified bismuth quadruple therapy as empirical firstline and secondline treatment forHelicobacter pyloriin Chinese patients: an open label, randomised, crossover trial

Abstract: NCT 01760824.

Cited by 45 publications

References 29 publications

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

Antibiotic treatment forHelicobacter pylori: Is the end coming?

Helicobacter pylori eradication in the Swedish population

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