Treatment of H. pylori Infection: A Review

Candelli, Marcello; Nista, Enrico Celestino; Carloni, Emilia; Pignataro, Giulia; Zocco, M.A.; CAZZATO, A; Campli, C. Di; Fini, Lucia; Gasbarrini, Giovanni; Gasbarrini, Antonio

doi:10.2174/0929867053363027

Cited by 15 publications

(6 citation statements)

References 125 publications

(137 reference statements)

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“…The very fact that new antimicrobial combinations are being explored, the results of which appear regularly in the medical literature, is evidence that no single regimen serves to provide the ideal treatment the clinicians require. Antimicrobial-related adverse effects represent the main cause of poor compliance, which often lead to eradication failure [21, 23, 64]. This is, for instance, the case of rifabutin-based regimens, which – despite the high cure rates [65,66,67] – are not devoid of serious adverse events [42, 43].…”

Section: Discussionmentioning

confidence: 99%

“…Several European guidelines [for reviews, see [15,21,22,23,24] suggest the use of a 7-day triple therapy, comprising a proton pump inhibitor (or ranitidine bismuth citrate), clarithromycin and amoxicillin or metronidazole, as first-line therapy, whilst a 7-day quadruple therapy (proton pump inhibitor, bismuth salts, tetracycline, and metronidazole) is indicated for eradication failure patients. However, increasing evidence suggests that the success rate following such regimens is decreasing in several countries.…”

Section: Therapy Of Helicobacter Pylori Infectionmentioning

confidence: 99%

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Eradication of <i>Helicobacter pylori</i>: Are Rifaximin-Based Regimens Effective?

Gasbarrini

Pelosini

et al. 2006

Digestion

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Rifaximin is a non-absorbed semisynthetic rifamycin derivative with a broad spectrum of antibacterial activity including Gram-positive and Gram-negative bacteria, both aerobes and anaerobes. Although originally developed for the treatment of infectious diarrhea, the appreciation of the pathogenic role of gut bacteria in several organic and functional gastrointestinal diseases has increasingly broadened its clinical use. Being the antibiotic active against Helicobacter pylori, even towards clarithromycin-resistant strain, and being the primary resistance very rare, several investigations explored its potential use for eradication of the microorganism. Rifaximin alone proved to be effective, but even the highest dose (1,200 mg daily) gave a cure rate of only 30%. Dual and triple therapies were also studied, with the better results obtained with rifaximin-clarithromycin and rifaximin-clarithromycin-esomeprazole combinations. However, the eradication rates (60–70%) obtained with these regimens were still below the standard set by the Maastricht Consensus guidelines. Although rifaximin-based eradication therapies are promising, new antimicrobial combinations (with and without proton pump inhibitors) need to be explored in well-designed clinical trials including a large cohort of H. pylori-infected patients. The remarkable safety of rifaximin will allow high-dose regimens of longer duration (e.g. 10 or 14 days) to be tested with confidence in the hope of achieving better eradication rates. A drawback of rifaximin could be its inability to reach sufficiently high concentrations in the gastric mucus layer under and within which H. pylori is commonly located and this would likely affect eradication rate. Taking these considerations into account, bioadhesive rifaximin formulations able to better and persistently cover gastric mucosa, or combination with mucolytic agents, such as pronase or acetylcysteine, need to be evaluated in order to better define the place of this antibiotic in our therapeutic armamentarium.

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Section: Discussionmentioning

confidence: 99%

Section: Therapy Of Helicobacter Pylori Infectionmentioning

confidence: 99%

Eradication of <i>Helicobacter pylori</i>: Are Rifaximin-Based Regimens Effective?

Gasbarrini

Pelosini

et al. 2006

Digestion

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“…Levofloxacin is an isomer of ofloxacin with a broad spectrum of activity against several Gram‐positive and Gram‐negative bacteria . Its antibacterial effect is based on the inhibition of bacterial topoisomerase II .…”

Section: Introductionmentioning

confidence: 99%

Levofloxacin and proton pump inhibitor‐based triple therapy versus standard triple first‐line therapy for Helicobacter pylori eradication

Liao

et al. 2014

Pharmacoepidemiology and Drug

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“…During the relatively short period of time that we have known about H. pylori, there have been many different treatment regimens developed (reviewed in [16]. In fact, in 1994 there was a consensus from the National Institute of Health (USA) [17], followed two years later by the Maastricht Consensus from the European Helicobacter Study Group (Netherlands) [18], which established treatment recommendations to treat H. pylori infection.…”

Section: Introduction Of the Enemy: Helicobacter Pylorimentioning

confidence: 99%

“…These include fluoroquinolones (such as levofloxacin), rifamycins (such as rifabutin and rifampicin), nitrofurans (such as furazolidone) and other members (such as doxycycline) within families that are already used to treat H. pylori infection (reviewed in [16, 21]. Of note, resistance has been found to all utilized primary and secondary antibiotics, as well as, to many of the antimicrobials used for rescue therapy.…”

Section: Introduction Of the Enemy: Helicobacter Pylorimentioning

confidence: 99%

Whos Winning the War? Molecular Mechanisms of Antibiotic Resistance in Helicobacter pylori

Jones¹,

Heon²,

Merrell³

2008

CDTH

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The ability of clinicians to wage an effective war against many bacterial infections is increasingly being hampered by skyrocketing rates of antibiotic resistance. Indeed, antibiotic resistance is a significant problem for treatment of diseases caused by virtually all known infectious bacteria. The gastric pathogen Helicobacter pylori is no exception to this rule. With more than 50% of the world’s population infected, H. pylori exacts a tremendous medical burden and represents an interesting paradigm for cancer development; it is the only bacterium that is currently recognized as a carcinogen. It is now firmly established that H. pylori infection is associated with diseases such as gastritis, peptic and duodenal ulceration and two forms of gastric cancer, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. With such a large percentage of the population infected, increasing rates of antibiotic resistance are particularly vexing for a treatment regime that is already fairly complicated; treatment consists of two antibiotics and a proton pump inhibitor. To date, resistance has been found to all primary and secondary lines of antibiotic treatment as well as to drugs used for rescue therapy.

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Treatment of H. pylori Infection: A Review

Cited by 15 publications

References 125 publications

Eradication of <i>Helicobacter pylori</i>: Are Rifaximin-Based Regimens Effective?

Eradication of <i>Helicobacter pylori</i>: Are Rifaximin-Based Regimens Effective?

Levofloxacin and proton pump inhibitor‐based triple therapy versus standard triple first‐line therapy for Helicobacter pylori eradication

Whos Winning the War? Molecular Mechanisms of Antibiotic Resistance in Helicobacter pylori

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