Esomeprazole-Based Therapy in Helicobacter pylori Eradication: Any Effect by Increasing the Dose of Esomeprazole or Prolonging the Treatment?

Gisbert, Javier P.; Domínguez-Muñoz, Antonio; Domínguez-Martín, Antonio; Gisbert, José Luis; Marcos, Santiago

doi:10.1111/j.1572-0241.2005.00178.x

Cited by 31 publications

(48 citation statements)

References 36 publications

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“…As previously mentioned, it has been generally recommended that performing culture after a first eradication failure is not necessary and therefore assessing H. pylori sensitivity to antibiotics only after failure of the second treatment may be suggested in clinical practice [Malfertheiner et al 2007;De Boer et al 2000b; European Helicobacter pylori Study Group 1997]. However, the utility of the culture (with consequent antibiotic susceptibility testing) and the moment when it must be performed after eradication failure are both controversial [Gisbert, 2008a[Gisbert, , 2005b. It is evident that, as pretreatment antibiotic resistance is the most important factor in nonresponse to initial treatment [Dore et al 2000;Houben et al 1999;Peitz et al 1999;Van Der Wouden et al 1999;Tompkins et al 1997], knowledge of the organism's antibiotic susceptibility may represents an aid in selecting the therapy regimen.…”

Section: Introductionmentioning

confidence: 99%

“…Some authors have evaluated, in the same study, different regimens after failure of two eradication treatments, which provide interesting information about cumulative, and not only absolute, eradication rates [Gisbert et al 2008a[Gisbert et al , 2005b. For example, in the study by Gasbarrini et al [2000a], a total of 2606 patients were administered a PPI, tinidazole and clarithromycin for 1 week.…”

Section: Authormentioning

confidence: 99%

“…However, several large clinical trials and meta-analyses have shown that the most commonly used first-line therapies including proton-pump inhibitors (PPIs) plus two antibiotics may fail in up to 20% of patients [Gisbert et al 2007d[Gisbert et al , 2000b, and in the clinical routine setting, the treatment failure rate might be even higher. Moreover, during the last few years, the efficacy of PPIbased regimens seems to be decreasing, and several studies have reported intention-to-treat eradication rates lower than 75% [Paoluzi et al 2006;Calvet et al 2005;Gisbert et al 2005b;Vakil et al 2004;Hawkey et al 2003;Veldhuyzen Van Zanten et al 2003;Laine et al 2000Laine et al , 1998] and even lower than 50% [Altintas et al 2004;Gumurdulu et al 2004;Della Monica et al 2002]. Antibiotic resistance to clarithromycin has been identified as one of the major factors affecting our ability to cure H. pylori infection, and the rate of resistance to this antibiotic seems to be increasing in many geographical areas [Egan et al 2008;Megraud, 2004;Vakil et al 1998].…”

Section: Introductionmentioning

confidence: 99%

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Review: Second-line rescue therapy of Helicobacter pylori infection

Gisbert

2009

Therap Adv Gastroenterol

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Helicobacter pylori infection is the main known cause of gastritis, gastroduodenal ulcer disease and gastric cancer. After more than 20 years of experience in H. pylori treatment, however, the ideal regimen to treat this infection has still to be found. Nowadays, apart from having to know well first-line eradication regimens, 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 first-line clarithromycin-based regimen was used, a second-line metronidazole-based treatment (quadruple therapy) may be used afterwards, and then a levofloxacin-based combination would be a third-line '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, quadruple regimen may be reserved as a third-line 'rescue' option. Finally, rifabutin-based 'rescue' therapy constitutes an encouraging empirical fourth-line 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: Introductionmentioning

confidence: 99%

Section: Authormentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Review: Second-line rescue therapy of Helicobacter pylori infection

Gisbert

2009

Therap Adv Gastroenterol

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“…However, several large clinical trials and metaanalyses have shown that the most commonly used firstline therapies-including proton pump inhibitors (PPIs) plus two antibiotics-may fail in up to 20% of patients [4,5] , and in the clinical routine setting, the treatment failure rate might be even higher. Moreover, during the last few years, the efficacy of PPI-based regimens seems to be decreasing, and several studies have reported intention-to-treat eradication rates lower than 75% [6][7][8][9][10][11][12][13][14] and even lower than 50% [15,16] . Antibiotic resistance to clarithromycin has been identified as one of the major factors affecting our ability to cure H pylori infection, and the rate of resistance to this antibiotic seems to be increasing in many geographical areas [17,18] .…”

Section: Introductionmentioning

confidence: 99%

“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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“…Esomeprazole-based triple therapy is by 8% more effective than that with omeprazole although this difference is statistically insignificant (1,2). Data about the necessary duration of the treatment with esomeprazole and other PPIs are contradictory (1,4,13). The supplementation of Bio Gaya probiotic is of importance, too.…”

Section: Discussionmentioning

confidence: 99%

Esomeprazole-based sequential therapy and probiotic for Helicobacter pylori eradication

Stamboliyska

Kotsev

2013

SSM

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PURPOSE: The objective of the present study was to determine the effectiveness of esomeprazole-based sequential therapy and Bio Gaya probiotic for the treatment of Helicobacter pylori-infection (Hp-infection) with associated gastroduodenal diseases. MATERIAL AND METHODS:The study covered 104 patients with dominating upper dyspeptic syndrome and Hp-infection examined by means of two or more methods. Esomeprazole-based sequential therapy consisted in amoxycillin in a dose of 1,0 g two times daily for the first five days followed by clarithromycin and metronidazole in a dose of 500 mg two times daily for the next 5 days. A Bio Gaya probiotic was added during the 10-day treatment. RESULTS: Hp-infection was successfully treated in 98 patients (94,2%) and in 79 out of 81 naive ones (97% of the cases). This therapy proved effective in

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Esomeprazole-Based Therapy in Helicobacter pylori Eradication: Any Effect by Increasing the Dose of Esomeprazole or Prolonging the Treatment?

Cited by 31 publications

References 36 publications

Review: Second-line rescue therapy of Helicobacter pylori infection

Review: Second-line rescue therapy of Helicobacter pylori infection

“Rescue” regimens after Helicobacter pylori treatment failure

Esomeprazole-based sequential therapy and probiotic for Helicobacter pylori eradication

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