Empiric use of standard triple therapy in<i>Helicobacter pylori</i>eradication does not require readjustment in the clarithromycin resistance cut-off point

Malfertheiner, Peter; Mégraud, Françis; Rokkas, Theodore; Gisbert, Javier P.

doi:10.1136/gutjnl-2023-329712

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…Moreover, the eradication rate achieved with sequential therapy was less than the recommended optimal eradication rate for any regimen which is 90%. 13,19 A recent meta-analysis showed that the sequential therapy has an overall eradication rate of 83% which is similar to the finding in the current study. 20 In the observational study by Bhattarai et al in similar geographic set up, the eradication rate of 83.3% was reported with sequential therapy.…”

Section: Discussionsupporting

confidence: 90%

“…8 It is recommended that bismuth-based quadruple therapy be used in area of high clarithromycin resistance which is found to be 22% in Nepal. 13,14 However, bismuth is not available in Nepal. Through this study, we aim to compare the eradication rates of a 14-day sequential therapy and levofloxacin-based therapy and hence to know whether sequential therapy can serve as the first line of therapy in this setting.…”

Section: Introductionmentioning

confidence: 99%

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Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Ranjan,

Neupane,

Maharjan

et al. 2024

Journal of Gastrointestinal Infections

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Background Helicobacter pylori eradication rates of the commonly used regimens vary among countries and even among different regions of the same country. We aimed to compare the eradication rate and safety of sequential therapy with levofloxacin-based triple therapy. Methods A comparative single-center study was conducted between October 2022 and November 2023 after obtaining ethical approval. Patients in group A received 14 days of levofloxacin-based triple therapy and those in group B received 14 days of sequential therapy. The eradication of H. pylori was assessed 4 weeks after the completion of the assigned regimens. The data regarding adverse events were also recorded. Results Among 150 patients (group A: 70, group B: 80) with mean age of 41.7 ± 15.0 years, 67 (44.6%) were male. The eradication was achieved in 65 (92.9%) in group A and 63 (78.8%) in group B, respectively (p = 0.01). All the patients in group A and 76 (95%) patients in group B had good compliance with medication. Adverse events were noticed in 7 (10%) in group A compared to 31 (38.7%) in group B (p < 0.001). The most common adverse events in group A and group B were drug-related diarrhea (3 [4.3%] vs. 11 [13.7%]), gastrointestinal intolerance (2 [2.8%] vs. 6 [7.5%]), and bad/metallic taste (1 [1.4%] vs. 22 [27.5%]). No serious adverse events were noted in both groups. Conclusion Sequential therapy is significantly less effective and has more nonserious adverse events compared to levofloxacin-based triple therapy in eradication of H. pylori.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Ranjan,

Neupane,

Maharjan

et al. 2024

Journal of Gastrointestinal Infections

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Recent trends in Helicobacter pylori management: harnessing the power of AI and other advanced approaches

Addissouky,

Wang,

El Sayed

et al. 2023

Beni-Suef Univ J Basic Appl Sci

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Background Helicobacter pylori (H. pylori) is a bacterial infection that is prevalent and affects more than half of the world's population, causing stomach disorders such as gastritis, peptic ulcer disease, and gastric cancer. Main body The diagnosis of H. pylori infection relies on invasive and non-invasive techniques emerging artificial intelligence, and antibiotic therapy is available, but antibiotic resistance is a growing concern. The development of a vaccine is crucial in preventing H. pylori-associated diseases, but it faces challenges due to the bacterium's variability and immune escape mechanisms. Despite the challenges, ongoing research into H. pylori's virulence factors and immune escape mechanisms, as well as the development of potential vaccine targets, provides hope for more effective management and prevention of H. pylori-associated diseases. Recent research on H. pylori's immune escape mechanisms and novel immune checkpoint inhibitors could also lead to biomarkers for early cancer detection. Therefore, experts have suggested a combination of traditional and herbal medicine with artificial intelligence to potentially eradicate H. pylori. Short conclusion H. pylori infection remains a significant global health problem, but ongoing research into its properties and advanced technologies in addition to the combination of traditional and herbal medicine with artificial intelligence may also lead to the eradication of H. pylori-associated diseases. Graphical abstract

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Molecular dynamics simulation-driven focused virtual screening and experimental validation of Fisetin as an inhibitor of Helicobacter pylori HtrA protease

Gao,

Jiang,

Duan

et al. 2024

Preprint

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Helicobacter pylori (H. pylori, Hp) is a primary contributor to various stomach diseases, including gastritis and gastric cancer. This bacterium can colonize gastric epithelial cells, compromising their integrity and leading to the development of these conditions. While antibiotics are the mainstay of treatment for H. pylori infections, their widespread use has led to serious issues with drug resistance. High-temperature requirement A (HtrA), an important virulence factor of H. pylori, emerges as a promising target for the design of new inhibitors. In this study, we employed molecular docking, molecular dynamics simulation (MDs), and in vitro experimental validation to identify potential active components that specifically target HtrA, effectively combating H. pylori. Based on the results of molecular docking and literature reports, 8 potential natural compounds targeting HtrA were found: Camelliaside B, Rehmanioside A, Hesperidin, Quercetin, Fisetin, Colchicine, Apigenin and Geniposide. MDs further revealed that Fisetin, Geniposide, and Quercetin show promising stability and interactions with HtrA. Importantly, in vitro experiments, including casein hydrolysis assays and antibacterial sensitivity tests, demonstrated that Fisetin observably inhibited the hydrolysis of casein by HtrA and effectively suppressed the growth of H. pylori. Overall, our findings highlight Fisetin as a potential therapeutic drug that targets HtrA, offering new tack for the development of lead compounds and potential drugs against H. pylori infections.

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Empiric use of standard triple therapy inHelicobacter pylorieradication does not require readjustment in the clarithromycin resistance cut-off point

Cited by 3 publications

References 8 publications

Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Recent trends in Helicobacter pylori management: harnessing the power of AI and other advanced approaches

Molecular dynamics simulation-driven focused virtual screening and experimental validation of Fisetin as an inhibitor of Helicobacter pylori HtrA protease

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