Helicobacter pylori treatment results in Slovenia in the period 2013-2015 as a part of European Registry on Helicobacter pylori Management

Abstract

BackgroundHelicobacter pylori (H. pylori) is the most common chronic bacterial infection in the world affecting over 50% of the world’s population. H. pylori is a grade I carcinogen, responsible for the development of 89 % of noncardia gastric cancers. In the present study we analyzed the data for H. pylori eradication treatments in Slovenia.Patients and methodsSlovenia is a part of the European Registry on Helicobacter pylori Management from the beginning. In seven medical institutions data for H. pylori eradication treatments was collected for 1774 patients from April 16th 2013 to May 15th 2016. For further modified intention to treat (mITT) analysis 1519 patients were eligible and for per protocol (PP) analysis 1346 patients.ResultsPatients’ dropout was 11.4%. Eradication rate for 7 day triple therapy with proton pump inhibitor (PPI) + Clarithromycin (C) + Amoxicillin (A) was 88.7% PP and 72.0% mITT; for PPI + C + Metronidazole (M) 85.2% PP and 84.4% mITT. Second line 14 day therapy PPI + A + Levofloxacin had 92.3% eradication rate PP and 87.1% mITT. Ten to fourteen day Bismuth quadruple therapy was the therapy in difficult to treat patients. At the end all patients that adhered to prescribed regimens were cured of their H. pylori infection.ConclusionsHigh dropout rate deserves further analysis. Slovenia is still a country with < 15% H. pylori resistance to clarithromycin, triple therapy with PPI plus two antibiotics reaches PP eradication rate > 85%, but mITT eradication rates are suboptimal.

Treatment of Helicobacter pylori infection in 2018

“…The Registry has received international recognition and was awarded the National Scholar Award by the United European Gastroenterology. This year, published data from the Registry regarding Slovenia demonstrate low resistance to clarithromycin, where triple therapy with PPI plus two antibiotics reaches eradication rates >85% …”

“…The fifth Chinese national consensus report, 91 where triple therapy with PPI plus two antibiotics reaches eradication rates >85%. 96…”

Helicobacter pylori resistance to antibiotics in Primorsko-goranska county

“…Na oba antibiotika detektirana je rezistencija H. pylori. Prema novijim istraživanjima u Italiji, Sloveniji, Španjolskoj i ostalim mediteranskim zemljama rezistencija na amoksicilin je sporadična, dok je rezistencija na metronidazol izražena [6][7][8][9] . Levofloksacin je fluorokinolon koji se uz amoksicilin i metronidazol koristi kao dio trojne terapije u drugoj liniji liječenja, nakon neuspjeha prve linije, a otpornost helikobaktera na fluorokinolone znatno varira u različitim regijama, ovisno o njihovoj primjeni.…”

Gastric histopathological features after the administration of omeprazole, amoxicillin, and clarithromycin in gastritis Helicobacter pylori rat model

“…Studies with human subjects are widely conducted, but the presence of confounding factors along with a high-enough dropout rate often produces inconsistent results, low validity, and very little research that discusses the effect of a standard first-line eradication regimen on gastric histopathological features in the management of gastritis by H. pylori [ 16 , 17 ]. This work aimed to assess the histopathological features and the severity of gastritis in a rat model inoculated with H. pylori , after treatment with omeprazole, amoxicillin, and clarithromycin as the standard first-line eradication regimen.…”