The influence of in vitro nitroimidazole resistance on the efficacy of nitroimidazole-containing anti-Helicobacter pylori regimens: a meta-analysis

Wouden, EJ van der

doi:10.1016/s0002-9270(99)00258-0

Cited by 118 publications

(85 citation statements)

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“…Pretreatment antibiotic resistance is the most important factor in nonresponse to initial treatment [25][26][27][28][29] . Thus, the choice of a second-line treatment depends on which treatment was used initially, as it would appear that retreatment with the same regimen cannot be recommended [30] .…”

Section: Is It Necessary To Perform Culture After Failure Of the Firsmentioning

confidence: 99%

“…Firstly, omeprazole plus amoxicillin, with a high dose of both the antibiotic and the antisecretor, could, in theory, be recommended [128,130] ; however, we must remember that this "old-fashioned" dual combination has achieved disappointing results in many countries. Therefore, a second antibiotic should be added, and at this point a difficult decision appears, as both antibiotics used in the first trial (clarithromycin and metronidazole) are capable of inducing secondary resistance to H pylori, playing a negative role in future efficacy [25][26][27][28][29]131] . Nevertheless, the following possibilities exist:…”

Section: Rbc Tetracycline and Metronidazolementioning

confidence: 99%

“…Readministering metronidazole: Due to the fact that metronidazole resistance is frequent and clinically relevant [25][26][27][28] , if this antibiotic is readministered, it should be used within a bismuth-based quadruple regimen (thus PPI might reduce the negative effect of metronidazole resistance [28,58,132,133] ). With this regimen, eradication rates up to 80% have been achieved [45] .…”

Section: Rbc Tetracycline and Metronidazolementioning

confidence: 99%

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“Rescue” regimens after Helicobacter pylori treatment failure

Gisbert¹

2008

WJG

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Helicobacter pylori (H pylori ) infection is the main cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. After more than 20 years of experience in H pylori treatment, in my opinion, the ideal regimen to treat this infection is still to be found. Currently, apart from having to know first-line eradication regimens well, we must also be prepared to face treatment failures. Therefore, in designing a treatment strategy we should not focus on the results of primary therapy alone, but also on the final (overall) eradication rate. The choice of a "rescue" treatment depends on which treatment is used initially. If a clarithromycinbased regimen was used initially, a subsequent metronidazole-based treatment (quadruple therapy) may be used afterwards, and then a levofloxacinbased combination would be a third "rescue" option. Alternatively, it has recently been suggested that levofloxacin-based rescue therapy constitutes an encouraging second-line strategy, representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure, with the advantage of efficacy, simplicity and safety. In this case, a quadruple regimen may be reserved as a third-line rescue option. Finally, rifabutin-based rescue therapy constitutes an encouraging empirical fourthline strategy after multiple previous eradication failures with key antibiotics such as amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin. Even after two consecutive failures, several studies have demonstrated that H pylori eradication can finally be achieved in almost all patients if several rescue therapies are consecutively given. Therefore, the attitude in H pylori eradication therapy failure, even after two or more unsuccessful attempts, should be to fight and not to surrender.

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Section: Is It Necessary To Perform Culture After Failure Of the Firsmentioning

confidence: 99%

Section: Rbc Tetracycline and Metronidazolementioning

confidence: 99%

Section: Rbc Tetracycline and Metronidazolementioning

confidence: 99%

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“Rescue” regimens after Helicobacter pylori treatment failure

Gisbert¹

2008

WJG

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“…Furthermore, the dose and duration of Bismuth therapy are also important variables, especially in case of resistance to Metronidazole [65] . In most previous studies, suboptimal dose and duration have been used and, as expected, unsatisfactory results were achieved [66] .…”

Section: Therapymentioning

confidence: 99%

Helicobacter pylorieradication in West Asia: A review

Fakheri

Bari

Aarabi

et al. 2014

WJG

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The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. However, no review article has yet evaluated and compared the efficacy of different regimens among different countries of this region. Therefore, we conducted a review to select the best options and provide recommendations for H. pylori treatment in this geographic region. A search through PubMed was carried out to obtain relevant randomized clinical trials published in English language up to June 2013. According to the results, among different therapeutic regimens used as the first-line protocols, 10-d Bismuth-Furazolidone/Metronidazole quadruple therapy, 14-d Clarithromycin-containing hybrid therapy and 14-d quadruple therapy including a proton pump inhibitor + Bismuth + Tetracycline (500 mg QID) + Metronidazole (500 mg TDS) seemed to be appropriate options. Among second-line therapeutic regimens, Bismuthbased quadruple therapies containing Tetracycline and Furazolidone/Metronidazole, triple therapy containing Amoxicillin and Gatifloxacin and Quadruple therapy including Bismuth + Azithromycin and Ofloxacin seemed to be effective options. Third-line therapies were not evaluated in West Asia; most guidelines, however, recommend choosing optimal eradication regimen according to the pattern of antibiotic susceptibility of H. pylori . Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same. Core tip: The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. The present study evaluates and compares the efficacy of different regimens among different countries of this region. Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same.

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“…La recopilación de la información mundial publicada entre los años 1993 y 1997 destaca la influencia de la eficiencia del tratamiento con Mtz, calculándose que la tasa de erradicación es de 90% en cepas sensibles, pero menor a 75% en cepas resistentes a este antibiótico, aunque la elección de otras drogas y la duración del tratamiento influyen en la eficiencia final de éste 22 . Por otra parte, datos recopilados entre 1983 y 1997, muestran que la resistencia a Mtz reduce el éxito de la terapia en un promedio de 37,7%, mientras que la frecuencia de resistencia en aislados clínicos varía desde 10% en Japón 23 a 90% en India 24 , alcanzando 50% o más entre las cepas aisladas en Estados Unidos y Europa Occidental 25,26 .…”

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Resistencia antimicrobiana en Helicobacter pylori: aspectos clínicos y moleculares

Valenzuela

et al. 2003

Rev. méd. Chile

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Helicobacter pylori is a relevant pathogen for gastroduodenal diseases in human beings. Although its eradication often improves gastroduodenal diseases, H pylori is acquiring an elevated rate of resistance to various antimicrobials, such as metronidazole, clarithromycin, tetracycline and amoxicillin. Multi-drug resistance is a major problem to select the appropriate treatment of infectious diseases. To improve our understanding on the complexity of the problem, in this article we review the resistance mechanisms and give an update on H pylori antimicrobial resistance (Rev Méd Chile 2003; 131: 1313-20).

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The influence of in vitro nitroimidazole resistance on the efficacy of nitroimidazole-containing anti-Helicobacter pylori regimens: a meta-analysis

Abstract: NIR decreases treatment efficacy. Treatment duration and choice of other drugs influence the impact of NIR on treatment efficacy. If NIR is present, a nitroimidazole-containing regimen should be avoided or a quadruple regimen should be given for > 1 wk.

Cited by 118 publications

References 0 publications

“Rescue” regimens after Helicobacter pylori treatment failure

“Rescue” regimens after Helicobacter pylori treatment failure

Helicobacter pylorieradication in West Asia: A review

Resistencia antimicrobiana en Helicobacter pylori: aspectos clínicos y moleculares

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