The efficacy of culture‐guided <i>versus</i> empirical therapy with high‐dose proton pump inhibitor as third‐line treatment of <scp><i>Helicobacter pylori</i></scp> infection: A real‐world clinical experience

Wang, Jiunn-Wei; Hsu, Ping‐I; Lin, Ming‐Hong; Kao, John Y.; Tsay, Feng‐Woei; Wu, I-Ting; Shie, Chang‐Bih; Wu, Deng‐Chyang

doi:10.1111/jgh.15942

Cited by 4 publications

(3 citation statements)

References 31 publications

(83 reference statements)

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“…For example, in the highly resistant population of levofloxacin, 10‐day tetracycline‐levofloxacin quadruple therapy is more effective than amoxicillin‐levofloxacin quadruple therapy for the eradication‐resistant H. pylori 25 . For H. pylori ‐infected patients with at least two failed eradication attempts, culture‐guided therapy with high‐dose proton pump inhibitors (PPIs) has advantages over empirical therapy with high‐dose PPI 26 . David Y Graham is the author with the highest h‐index who is working on H. pylori –resistance diagnostics 27 .…”

Section: Discussionmentioning

confidence: 99%

“…25 For H. pylori-infected patients with at least two failed eradication attempts, culture-guided therapy with high-dose proton pump inhibitors (PPIs) has advantages over empirical therapy with high-dose PPI. 26 David Y Graham is the author with the highest h-index who is working on H. pylori-resistance diagnostics. 27 By comparing with culture-based H. pylori susceptibility testing, it was found that targeted next-generation sequencing has stronger advantages in determining drug resistance of H. pylori.…”

Section: Analysis Of Authorsmentioning

confidence: 99%

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Bibliometric analysis of Helicobacter pylori resistance—from 2002 to 2022

Gao

Wang

et al. 2023

Helicobacter

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Background: Drug resistance in Helicobacter pylori severely affects the efficacy of eradication therapy, and a number of studies have been conducted on this issue. The aim of this study was to assess the progress in this field using a bibliometric approach. Materials and Methods:Publications related to H. pylori resistance from 2002 to 2022 were retrieved from the Web of Science database. Relevant information including titles, authors, countries, and keywords was extracted, and the data were processed using Excel, VOSviewer, and CiteSpace software for co-authorship, co-citation, and co-occurrence analysis. Results: From 2002 to 2022 (as of 09/24/2022), the field of H. pylori-resistance research produced a total of 2677 publications with a total of 75217 citations, with an overall upward trend in the annual number of articles published, reaching a peak of 204 in 2019. Articles were mainly published in Q1 or Q2 journals, with Helicobacter (TP = 261) publishing the most literature, Baylor College of Medicine (TP = 68) and Deng-chyang wu (TP = 38) being the most prolific institutions and authors, respectively. China and the United States were the locations of most of the articles, accounting for 35.08% of the global publication volume. Keyword co-occurrence analysis divided H. pylori-resistance research into four clusters: "Therapeutic Strategies," "Diseases," "Mechanism Research and Epidemiology," and "Drug Research." "Drug research" and burst detection indicate that the current research hotspot involves the selection and analysis of treatment strategies.Conclusions: H. pylori-resistance research has become a popular research field, and although there are significant contributions from Europe, the United States, and East Asia, there are significant imbalances between regions that cannot be ignored. In addition, the exploration of treatment strategies remains a key issue for research at the current stage.

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Section: Discussionmentioning

confidence: 99%

Section: Analysis Of Authorsmentioning

confidence: 99%

Bibliometric analysis of Helicobacter pylori resistance—from 2002 to 2022

Gao

Wang

et al. 2023

Helicobacter

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“… 2 , 33 , 34 When bacterial susceptibility is demonstrated, the regimen containing PPI, bismuth plus two susceptible antibiotics is not inferior to PPI with three susceptible antibiotics, and both are recommended as rescue therapy. 35 The gold standard for antibiotic susceptibility testing is the culture-based phenotypical method followed by endoscopic biopsy. Nevertheless, successful culture rate varies and may below 80% in patient who have had treatment failure, 34 and the culture of H. pylori is time-consuming and expensive.…”

Section: Possible Factors To Be Overcome For Rescue Therapy For Refra...mentioning

confidence: 99%

Rescue therapy for refractoryHelicobacter pyloriinfection: current status and future concepts

Wang

Kuo

et al. 2023

Therap Adv Gastroenterol

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Helicobacter pylori infection is an important issue worldwide, and several guidelines have been published for clinicians to achieve successful eradication. However, there are still some patients who remain infected with H. pylori after treatment. Clinicians should identify the reasons that caused treatment failure and find strategies to manage them. We have searched and organized the literature and developed methods to overcome factors that contribute to prior treatment failure, such as poor compliance, inadequate intragastric acid suppression, and antibiotic resistance. To improve compliance, telemedicine or smartphone applications might play a role in the modern world by increasing doctor–patient relationships, while concomitant probiotics could be administered to reduce adverse effects and enhance adherence. For better acid suppression, high-potency and high-dose proton-pump inhibitors or potassium-competitive acid blockers have preferable efficacy. To overcome antibiotic resistance, susceptibility tests either by culture or by genotyping are the most commonly used methods and have been suggested for antibiotic selection before rescue therapy, but empirical therapy according to detailed medical history could be an alternative. Eradication with a longer treatment period (14 days) has a better outcome than shorter period (7 or 10 days). Ultimately, clinicians should select antibiotics based on the patient’s history of drug allergy, previous antibiotic exposure, local antibiotic resistance, available medications, and cost. In addition, identifying patients with a high risk of cancer and shared decision-making are also essential for those who have experienced eradication failure.

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Independent risk factors predicting eradication failure of standard bismuth quadruple therapy for the first‐line treatment of Helicobacter pylori infection in Taiwan

Shie,

Tsay,

et al. 2024

Adv in Digestive Medicine

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Bismuth quadruple therapy is recommended as the choice treatment for Helicobacter pylori (H. pylori) infection in areas of either low or high clarithromycin resistance in the Maastricht VI/Florence Consensus Report. However, the optimal treatment duration and drug dosages of bismuth quadruple therapy remain unclear. The study aimed to search the independent risk factors predicting eradication failure of standard bismuth quadruple therapy in the first‐line treatment of H. pylori infection. From July 2014 to June 2022, 274 H. pylori‐infected patients who received 10‐day or 14‐day bismuth quadruple therapy containing a proton pump inhibitor, bismuth, tetracycline and metronidazole were included for the study. Post‐treatment H. pylori status was assessed at least 4 weeks after completion of treatment. The relationships between eradication rate and 13 clinical parameters were analyzed by univariate and multivariate analyses. The eradication rates of standard bismuth quadruple therapy were 93.8% and 94.2% by intention‐to‐treat and per‐protocol analyses, respectively. Univariate analysis revealed that patients harboring metronidazole‐resistant strains had a lower eradication rate than those harboring metronidazole‐susceptible strains (88.7% [55/62] vs. 96.7% [148/153]). The other factors including smoking, treatment duration and drug adherence were not significantly associated with cure rate. Multivariate analysis revealed that metronidazole resistance of H. pylori was the only independent risk factors related to eradication failure of standard bismuth quadruple therapy with an odds ratio of 3.8 (95% CI: 1.2–12.4). In conclusion, metronidazole resistance is an independent risk factor predicting eradication failure of standard bismuth quadruple therapy in the first‐line treatment of H. pylori infection. There is no difference in eradication efficacy between 10‐day and 14‐day bismuth quadruple therapies in Taiwan.

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The efficacy of culture‐guided versus empirical therapy with high‐dose proton pump inhibitor as third‐line treatment of Helicobacter pylori infection: A real‐world clinical experience

Cited by 4 publications

References 31 publications

Bibliometric analysis of Helicobacter pylori resistance—from 2002 to 2022

Bibliometric analysis of Helicobacter pylori resistance—from 2002 to 2022

Rescue therapy for refractoryHelicobacter pyloriinfection: current status and future concepts

Independent risk factors predicting eradication failure of standard bismuth quadruple therapy for the first‐line treatment of Helicobacter pylori infection in Taiwan

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