<i>Helicobacter pylori</i> eradication in Western Australia using novel quadruple therapy combinations

Tay, Chin Yen; Windsor, Helen M.; Thirriot, F.; Lü, Wei; Conway, Charles R.; Perkins, Timothy T.; Marshall, Barry J.

doi:10.1111/apt.12089

Cited by 62 publications

(58 citation statements)

References 59 publications

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“…Th ere are no published studies of its use as a salvage therapy in North America. Nonrandomized studies from Russia, Ireland and Australia utilizing three-and four-drug regimens, have reported ITT eradication rates ranging from 60 to 86% for furazolidone salvage regimens (211)(212)(213). Th e lack of RCTs reporting the comparative effi cacy of furazolidone salvage therapy and its potential for harms including hypotension, urticaria, gastrointestinal symptoms, and reversible hemolysis make it impossible to recommend its use as a salvage treatment.…”

Section: High-dose Dual Regimen With Amoxicillinmentioning

confidence: 99%

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,316

1,505

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Helicobacter pylori ( H. pylori ) infection is a common worldwide infection that is an important cause of peptic ulcer disease and gastric cancer. H. pylori may also have a role in uninvestigated and functional dyspepsia, ulcer risk in patients taking low-dose aspirin or starting therapy with a non-steroidal anti-infl ammatory medication, unexplained iron defi ciency anemia, and idiopathic thrombocytopenic purpura. While choosing a treatment regimen for H. pylori , patients should be asked about previous antibiotic exposure and this information should be incorporated into the decision-making process. For fi rst-line treatment, clarithromycin triple therapy should be confi ned to patients with no previous history of macrolide exposure who reside in areas where clarithromycin resistance amongst H. pylori isolates is known to be low. Most patients will be better served by fi rst-line treatment with bismuth quadruple therapy or concomitant therapy consisting of a PPI, clarithromycin, amoxicillin, and metronidazole. When fi rst-line therapy fails, a salvage regimen should avoid antibiotics that were previously used. If a patient received a fi rst-line treatment containing clarithromycin, bismuth quadruple therapy or levofl oxacin salvage regimens are the preferred treatment options. If a patient received fi rst-line bismuth quadruple therapy, clarithromycin or levofl oxacin-containing salvage regimens are the preferred treatment options. Details regarding the drugs, doses and durations of the recommended and suggested fi rst-line and salvage regimens can be found in the guideline. Asia and Central and South America ( 8,22 ). Th ere is, however, preliminary evidence that it may be falling in some previously high prevalence areas ( 22 ). People immigrating to North America from Asia and other parts of the world have a much higher prevalence of the infection than people born in North America ( 23 ). In one study, the seroprevalence among immigrants from East Asia was 70.1% ( 24 ). Hispanic immigrants to North America have higher rates of the infection than fi rst-or second-generation Hispanics who were born here ( 25 ). QUESTION 2: WHAT ARE THE INDICATIONS TO TEST FOR, AND TO TREAT, H. PYLORI INFECTION? RecommendationsSince all patients with a positive test of active infection with H. pylori should be off ered treatment, the critical issue is which patients should be tested for the infection (strong recommendation, quality of evidence: not applicable), All patients with active peptic ulcer disease (PUD), a past history of PUD (unless previous cure of H. pylori infection has been documented), low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) should be tested for H. pylori infection. Th ose who test positive should be off ered treatment for the infection (strong recommendation, quality of evidence: high for active or history of PUD, low for MALT lymphoma, low for history of endoscopic resection of EGC).In patients with uninvestigated d...

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Section: High-dose Dual Regimen With Amoxicillinmentioning

confidence: 99%

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,316

1,505

View full text Add to dashboard Cite

show abstract

“…Fiorini and colleagues reported mild-tomoderate side effects in 15% and 20% of patients in each treatment arm; however, all patients complied with at least 90% of the treatment [Fiorini et al 2013]. Gasbarrini and colleagues, Tay and coworkers and Yahav's group did not mention the number of patients with adverse events, though the latter author reported a treatment compliance of 97% [Gasbarrini et al 2000;Tay et al 2012;Yahav et al 2006].…”

Section: Safety and Side Effectsmentioning

confidence: 99%

Systematic review: third-line susceptibility-guided treatment for Helicobacter pylori infection

Puig

López-Góngora

Calvet

et al. 2016

Therap Adv Gastroenterol

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Background: Susceptibility-guided therapies (SGTs) have been proposed as preferable to empirical rescue treatments after two treatment failures. The aim of this study was to perform a systematic review and meta-analysis evaluating the effectiveness and efficacy of SGT as third-line therapy. Methods: A systematic search was performed in multiple databases. Studies reporting cure rates of Helicobacter pylori with SGT in third-line therapy were selected. A qualitative analysis describing the current evidence and a pooled mean analysis summarizing the cure rates of SGT in third-line therapy was performed. Results: No randomized controlled trials or comparative studies were found. Four observational studies reported cure rates with SGT in third-line treatment, and three studies which mixed patients with second-and third-line treatment also reported cure rates with SGT. The majority of the studies included the patients when culture had been already obtained, and so the effectiveness of SGT and empirical therapy has never been compared. A pooled mean analysis including four observational studies (283 patients) showed intention-to-treat and perprotocol eradication rates with SGT of 72% (95% confidence interval 56-87%; I 2 : 92%) and 80% (95% confidence interval 71-90%; I 2 : 80%), respectively. Conclusions: SGT may be an acceptable option as rescue treatment. However, cure rates are, at best, moderate and this approach has never been compared with a well-devised empirical therapy. The evidence in favor of SGT as rescue therapy is currently insufficient to recommend its use.

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“…This suggested that antibiotics together with proton pump inhibitors could be the optimal treatment for gastro-duodenal ulcers and dyspepsia in general, a simple and apparently benign approach that is only sometimes confounded by antibiotic resistance (Tay et al 2012).…”

Section: Helicobacter Pylorimentioning

confidence: 99%

Selye’s general adaptation syndrome: stress-induced gastro-duodenal ulceration and inflammatory bowel disease

Fink

2017

Journal of Endocrinology

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Hans Selye in a note to Nature in 1936 initiated the field of stress research by showing that rats exposed to nocuous stimuli responded by way of a 'general adaptation syndrome' (GAS). One of the main features of the GAS was the 'formation of acute erosions in the digestive tract, particularly in the stomach, small intestine and appendix'. This provided experimental evidence for the view based on clinical data that gastroduodenal (peptic) ulcers could be caused by stress. This hypothesis was challenged by Marshall and Warren's Nobel Prize (2005)-winning discovery of a causal association between Helicobacter pylori and peptic ulcers. However, clinical and experimental studies suggest that stress can cause peptic ulceration in the absence of H. pylori. Predictably, the etiological pendulum of gastric and duodenal ulceration has swung from 'all stress' to 'all bacteria' followed by a sober realization that both factors play a role, separately as well as together. This raises the question as to whether stress and H. pylori interact, and if so, how? Stress has also been implicated in inflammatory bowel disease (IBD) and related disorders; however, there is no proof yet that stress is the primary etiological trigger for IBD. Central dopamine mechanisms seem to be involved in the stress induction of peptic ulceration, whereas activation of the sympathetic nervous system and central and peripheral corticotrophin-releasing factor appears to mediate stress-induced IBD.

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Helicobacter pylori eradication in Western Australia using novel quadruple therapy combinations

Cited by 62 publications

References 59 publications

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Systematic review: third-line susceptibility-guided treatment for Helicobacter pylori infection

Selye’s general adaptation syndrome: stress-induced gastro-duodenal ulceration and inflammatory bowel disease

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