Helicobacter pyloriinfection in hemodialysis patients: Susceptibility to amoxicillin and clarithromycin

Aydemır, Selim; Boyacioglu, Sedat; Gür, Gürden; Demirbilek, Müge; Can, Fusun Kamber; Korkmaz, Murat; Yılmaz, Uğur

doi:10.3748/wjg.v11.i6.842

Cited by 27 publications

(19 citation statements)

References 36 publications

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“…The prevalence of H. pylori infection in patients receiving CAPD and hemodialysis has been shown to be less than or equal to that in healthy subjects in various different geographic populations [17,18,19,20]. Our previous cohort study in 1997 in 539 Japanese hemodialysis patients with a mean treatment duration of 8.4 ± 0.3 years showed a prevalence of H. pylori infection of 48.6% (95% CI 44.3-52.9), which was significantly lower than that in dyspepsia patients with normal renal function (78.5%, 95% CI 74.1-82.4, p < 0.001) or healthy individuals undergoing screening (69.4%, 95% CI 60.3-77.5, p < 0.001) [17].…”

Section: Discussionmentioning

confidence: 99%

“…A recent large-scale Japanese epidemiological study showed that the infection rate has declined to 30-50%, especially in younger patients [16]. The prevalence of H. pylori infection in patients receiving dialysis has been investigated, and in most studies, the infection rate in patients with chronic kidney disease receiving continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis is shown to be equal to or lower than that in subjects with normal renal function in various population groups [17,18,19,20]. Thus, at a time when infection rates of H. pylori are decreasing, the infection rate in hemodialysis patients is also expected to decrease.…”

Section: Introductionmentioning

confidence: 99%

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Natural Course of Helicobacter pylori Infection in Japanese Hemodialysis Patients

Sugimoto

Sahara²,

Ichikawa³

et al. 2017

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Introduction:Helicobacter pylori (H. pylori) infection is one of the major risk factors for gastrointestinal morbidity in hemodialysis patients. Primary end point is to investigate H. pylori infection rate in hemodialysis patients. As secondary end point, we clarified whether pepsinogen (PG) level was related with H. pylori infection status in hemodialysis patients. Methods: Serum levels of PG I, II, and anti-H. pylori IgG antibody were assessed in 500 Japanese hemodialysis patients. Results:H. pylori infection rate was 15.0% (75/500; 95% CI 12.0-18.4). The duration of hemodialysis in H. pylori-positives was 4.6 ± 3.8 years, which was significantly shorter than in H. pylori-negatives (7.3 ± 6.9, p = 0.001). PG I levels positively correlated with the PG II level and PG I/II ratio (|R| = 0.661, p < 0.001, and |R| = 0.544, p <0.001, respectively). Using a cutoff value of 7.75, the sensitivity and specificity of PG I/II ratio for predicting H. pylori-negatives were 86.3 and 87.8%, respectively (area under the curve 0.930). Conclusions: In hemodialysis patients, infection rate with H. pylori was <20%, with lower rates in patients receiving hemodialysis for longer terms. A PG I/II ratio with a cutoff value of 7.75 may be useful for screening for H. pylori status.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Natural Course of Helicobacter pylori Infection in Japanese Hemodialysis Patients

Sugimoto

Sahara²,

Ichikawa³

et al. 2017

Digestion

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“…Resistance to amoxicillin does not appear to be a critical problem in H. pyloriinfected ESRD and non-ESRD patients in Turkey. By contrast, rates of resistance to clarithromycin are high, particularly in the ESRD population [45] . Prospective studies on the optimal therapy protocol, including antibiotic combination, dosage, and duration, in ESRD patients are warranted.…”

Section: H Pylori Therapy In Patients With End-stage Renal Diseasementioning

confidence: 95%

Helicobacter pylori: Effect of coexisting diseases and update on treatment regimens

Chang¹,

Hu²

2015

WJGPT

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“…According to this change, eradication rates with triple regimens of PPI/amoxicillin/clarithromycin in Japan have decreased from an initial 90.6 to 74.8% [26]. In hemodialysis patients, the incidence of clarithromycin resistance is known to be higher than that in healthy H. pylori -positive subjects, due to the frequent use of clarithromycin in daily practice [27]. In our study, the rate of clarithromycin-resistant strains in hemodialysis patients was high, 45.5%.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Reduced Dosage of Amoxicillin in an Eradication Therapy for Helicobacter pylori Infection in Patients on Hemodialysis: A Randomized Controlled Trial

et al. 2018

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Background: An optimum Helicobacter pylori-eradication regimen for hemodialysis patients is yet to be established because of different pharmacokinetics of amoxicillin involved between hemodialysis patients and healthy subjects. We investigated to establish appropriate doses of amoxicillin for H. pylori infection eradication in hemodialysis patients. Methods: Of 409 hemodialysis patients screened for H. pylori infection, 37 H. pylori-positive patients were randomized to different 1-week eradication regimens: esomeprazole 20 mg twice a day (b.i.d.) and clarithromycin 200 mg b.i.d., plus amoxicillin at either 750 mg b.i.d. (group A; conventional) or 250 mg b.i.d. (group B; experimental). Sixty-three patients with normal renal function received the conventional regimen (group C). Successful eradication was confirmed by urea breath testing. Results: Eradication rates of group B (reduced amoxicillin-regimen) were 84.2% in intention-to-treat analysis and 88.9% in per-protocol analysis, which were similar with group A (77.8 and 77.8%) and group C (74.6 and 81.0%). However, the incidence of adverse events in group A was significantly higher than that in group C (22.2 vs. 5.1%, p = 0.027). Conclusions: In H. pylori-positive hemodialysis patients, amoxicillin at 250 mg b.i.d. may be an appropriate scheme for eradication with equivalent effects to the conventional therapy and safety effects for adverse events.

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Helicobacter pyloriinfection in hemodialysis patients: Susceptibility to amoxicillin and clarithromycin

Abstract: Resistance to amoxicillin does not appear to be an important problem in H pylori-infected ESRD and non-uremic patients in our region. In contrast, the rates of resistance to clarithromycin are high, particularly in the ESRD population.

Cited by 27 publications

References 36 publications

Natural Course of <b><i>Helicobacter pylori</i></b> Infection in Japanese Hemodialysis Patients

Natural Course of <b><i>Helicobacter pylori</i></b> Infection in Japanese Hemodialysis Patients

Helicobacter pylori: Effect of coexisting diseases and update on treatment regimens

Efficacy of Reduced Dosage of Amoxicillin in an Eradication Therapy for Helicobacter pylori Infection in Patients on Hemodialysis: A Randomized Controlled Trial

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