Therapeutic success with bismuth-containing sequential and quadruple regimens in Helicobacter pylori eradication

Öztürk, Oğuzhan; Doganay, Levent; Çolak, Yaşar; Enç, Feruze Yılmaz; Ulasoglu, Celal; Özdil, Kamil; Tuncer, İlyas

doi:10.1016/j.ajg.2017.05.002

Cited by 15 publications

(25 citation statements)

References 43 publications

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“…Overall, 2189 studies were reviewed in the literature search. The selection criteria were applied as previously described, and a total of 25 studies were eligible for the final analysis (Figure ) . All enrolled studies were limited to randomized control trials, and a 3990 patients infected with H.pylori were enrolled (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…There were 15 trials describing the number of patients who had side effects . In the ITT analysis, the rates of adverse events in bismuth‐containing and non‐bismuth regimens were 28.8% and 26.5%, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…5 There were five articles 2,4,35-37 reporting the global antibiotic resistance rates of H pylori, and 1 2 trials were performed in areas with high clarithromycin resistance. 8,14,15,17,20,24,25,28,30,32,33 The analysis provided an OR of 1.60 (95% CI: 1.07-2.39, pooled ER: 74.9% vs 65.7%…”

Section: Analysis Of Eradication Rate In High Clarithromycin-resistmentioning

confidence: 99%

“…There were 18 trials [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] that were defined as "bismuth substitution," and the remaining seven trials 1-7 were "bismuth add-on." In six trials 14,16,20,24,26,29 with a study design of multiple arms, only the data of the groups that met the inclusion criteria were extracted and included for analysis.…”

Section: Study Selectionmentioning

confidence: 99%

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Bismuth supplements as the first‐line regimen for Helicobacter pylori eradication therapy: Systemic review and meta‐analysis

Kim

Chung

et al. 2019

Helicobacter

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Background and Aims An increase in the use of antibiotics leads to increased antibiotic resistance of Helicobacter pylori (H pylori). Consequently, it has been considered that the first‐line standard regimen should be changed. The main purpose of this study was to evaluate the efficacy of nonantibiotic (bismuth) supplements as a first‐line regimen for H pylori eradication. Methods We searched PubMed, EMBASE, CINAHL, and the Cochrane Library databases for randomized controlled trials (RCTs) reported in English and undertaken up until August 2018. A meta‐analysis of all randomized controlled trials comparing bismuth supplements with non‐bismuth‐containing regimens in H pylori eradication was performed. RCTs of classic bismuth‐containing quadruple therapy as a first‐line regimen were excluded. Results We identified twenty‐five randomized trials (3990 patients), and the total H pylori eradication rate, according to per protocol analyzed, was 85.8%. The odds ratio was 1.83 (95% confidence interval (CI). 1.57‐2.13). Among these RCTs, there were 7 RCTs for bismuth add‐on therapy, and the odds ratio was 2.81 (95% CI. 2.03‐3.89). When the studies were performed in a high clarithromycin resistance area (≥15%) or included patients with clarithromycin resistance, bismuth‐containing regimens were superior to non‐bismuth regimens. Moreover, the incidence of total side effects was insignificant. Conclusions Bismuth supplements as a first‐line regimen could be effective, with bismuth add‐on regimens being the most effective. Particularly, bismuth supplements showed the potential efficacy for clarithromycin‐resistant strains and would be the most viable alternative in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Analysis Of Eradication Rate In High Clarithromycin-resistmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

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Bismuth supplements as the first‐line regimen for Helicobacter pylori eradication therapy: Systemic review and meta‐analysis

Kim

Chung

et al. 2019

Helicobacter

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“…When doxycycline was used as first‐line therapy in different studies, the eradication rates ranged from 36%‐61% in triple therapies and 59.3%‐92.1% in quadruple therapies . As second‐line or third‐line rescue therapies, the eradication rates of triple therapies were similarly low (ranging from 0%‐40%), while the efficacies of quadruple therapies were between 67.4% and 91% .…”

Section: Discussionmentioning

confidence: 99%

Bismuth, rabeprazole, amoxicillin, and doxycycline as first‐line Helicobacter pylori therapy in clinical practice: A pilot study

Chen

et al. 2019

Helicobacter

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Background Bismuth‐containing quadruple therapy (BQT) is a recommended alternative first‐line therapy for Helicobacter pylori (H. pylori) infection. We aim to evaluate the efficacy and safety of a new BQT with amoxicillin and doxycycline as a first‐line treatment for H. pylori infection in clinical practice. Methods An open, prospective pilot clinical study including H. pylori‐positive outpatients who had never received eradication treatment was carried out. An RADB regimen (10 mg rabeprazole, 1000 mg amoxicillin, 100 mg doxycycline, and 220 mg colloidal bismuth tartrate, all given bid for 14 days) was prescribed by gastroenterologists. H. pylori eradication was confirmed by a 13C‐urea breath test performed at least 6 weeks after the end of treatment. Regimen efficacy was evaluated by per‐protocol (PP) and intention‐to‐treat (ITT) analyses. Results One hundred eighteen patients were included in the study. The eradication rate of RADB was 93.8% (105/112; 95% CI 89.2%‐98.3%) in PP analysis and 89.8% (106/118; 95% CI 84.3%‐95.4%) in ITT analysis. The patient compliance rate was 97.5% (115/118). The adverse event rate was 6.8% (8/118). Adverse events included asthenia, loss of appetite, dry mouth, heartburn, diarrhea, and abdominal pain. All adverse events disappeared after completion of therapy. Conclusion Our results suggest that 14‐day BQT with amoxicillin and doxycycline can be an effective and safe eradication regimen for first‐line therapy against H. pylori infection in clinical practice.

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Antofloxacin-based bismuth quadruple therapy is safe and effective in Helicobacter pylori eradication: A prospective, open-label, randomized trial

Zeng

Jiang

et al. 2021

Arab Journal of Gastroenterology

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Therapeutic success with bismuth-containing sequential and quadruple regimens in Helicobacter pylori eradication

Cited by 15 publications

References 43 publications

Bismuth supplements as the first‐line regimen for Helicobacter pylori eradication therapy: Systemic review and meta‐analysis

Bismuth supplements as the first‐line regimen for Helicobacter pylori eradication therapy: Systemic review and meta‐analysis

Bismuth, rabeprazole, amoxicillin, and doxycycline as first‐line Helicobacter pylori therapy in clinical practice: A pilot study

Antofloxacin-based bismuth quadruple therapy is safe and effective in Helicobacter pylori eradication: A prospective, open-label, randomized trial

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