Influence of clarithromycin on the bactericidal effect of amoxicillin in patients infected with clarithromycin-resistant strains of <i>H. pylori</i>

Furuta, Takahisa; Yamade, Mihoko; Kagami, Takuma; Suzuki, Takahiro; Higuchi, Tomohiro; Tani, Shinya; Hamaya, Yasushi; Iwaizumi, Moriya; Miyajima, Hiroaki; Umemura, Kazuo; Osawa, Satoshi; Sugimoto, Ken

doi:10.1136/gutjnl-2020-320705

Cited by 9 publications

(8 citation statements)

References 5 publications

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“…In a subgroup analysis of the aforementioned study, VA‐dual provided a higher eradication rate than VAC‐triple against clarithromycin‐resistant strains (92.3% vs.76.2%; p = 0.048). The higher eradication rate of VA‐dual than VAC‐triple can be attributed to the pharmacodynamic antagonism between amoxicillin and clarithromycin 11 . When clarithromycin acts on a clarithromycin‐resistant strain with a low MIC, the inhibition of ribosomal RNA also inhibits the synthesis of penicillin‐binding protein (PBP).…”

Section: Discussionmentioning

confidence: 99%

Impact of body size on first‐line Helicobacter pylori eradication success using vonoprazan and amoxicillin dual therapy

et al. 2021

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Background As a first‐line therapy for Helicobacter pylori, dual therapy with vonoprazan and amoxicillin (VA‐dual) provides an eradication rate similar to that of vonoprazan‐based triple therapy. As the factors associated with the eradication rate of H. pylori with VA‐dual are unknown,we investigated them in this study. Materials and Methods Overall, 163 patients diagnosed with H. pylori infection received VA‐dual (vonoprazan 20 mg twice daily and amoxicillin 750 mg twice daily for 7 d). The association between successful H. pylori eradication and the following patient clinical factors was analyzed: sex, age, height, weight, body surface area (BSA), body mass index (BMI), history of early gastric carcinoma and peptic ulcer, comorbidity of cirrhosis, alcohol consumption habit, smoking habit, common use of proton pump inhibitors, and concomitant use of drugs that are substratesof cytochrome P450 (CYP) 3A4. The association between post‐eradication adverse events and clinical factors was analyzed retrospectively. Results Successful H. pylori eradication was associated with a lower BSA (eradication rate: 90.8% in patients with BSA <1.723 vs. 79.6% in those with BSA ≥1.723; p = 0.045). The incidence of adverse events was higher in women than in men (adverse events: 40.0% in women vs. 19.4% in men; p = 0.004). Conclusions Successful H. pylori eradication with VA‐dual was associated with the small body size of patients. This therapy may have to be adjusted per body size.

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Section: Discussionmentioning

confidence: 99%

Impact of body size on first‐line Helicobacter pylori eradication success using vonoprazan and amoxicillin dual therapy

et al. 2021

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“…The incidence of peptic ulcers caused by H. pylori infection has markedly decreased in Japan because eradication therapy for H. pylori has been widely accepted. (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) Additionally, the infection rate of H. pylori has markedly decreased in Japan, (20,(31)(32)(33) especially in younger generations; the infection rate in junior high school students is <5%. (34) PPIs have recently become more frequently prescribed for secondary prevention of peptic ulcers and upper GI bleeding induced by NSAIDs and/or aspirin in Japan, (2,(35)(36)(37)(38) although the prescription of aspirin has increased in a time-dependent manner as demonstrated in Fig.…”

Section: Discussionmentioning

confidence: 99%

Decline incidence in upper gastrointestinal bleeding in several recent years: data of the Japan claims database of 13 million accumulated patients

Fujimoto

Tsuruoka

Esaki

et al. 2021

J. Clin. Biochem. Nutr.

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This study was to examine the recent trends in upper gastro intestinal bleeding in Japan using a large scale real world database. The incidence of upper gastrointestinal bleeding was evaluated in the Japan Medical Data Center claims database of 13,019,713 patients aged 20 to 74 years with traceability for 3 months from 2009 to 2014. The incidence was compared with peptic ulcers and gastroesophageal reflux disease. The prescrip tion of medications was also evaluated. The incidence of bleeding was 0.137%, 0.121%, 0.113%, 0.106%, 0.099%, and 0.105% during 2009 to 2014 with a time dependent decline (p<0.001). Peptic ulcers (>10 times higher than the incidence of bleeding) decreased with time (p<0.001), whereas gastroesophageal reflux disease increased (p = 0.006). Upper gastrointestinal bleeding was higher in male patients and older patients (60-74 years old) (p<0.001 respectively). The prescription rate of antithrombotic medications and proton pump inhibitors increased from 2009 to 2014 (p<0.001 respectively). The incidence of upper gastrointestinal bleeding decreased from 2009 to 2014 in this relatively large scale real world database in Japan, concomitant with the decrease in peptic ulcers. The decreased incidence might have been due to changes in the disease structure and therapeutic strategies over time.

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“… 135 Clarithromycin is known to affect as the inhibitor of ribosomal RNA (rRNA) and inhibit protein synthesis, including PBP, which is target to amoxicillin. 136 While this possibility is intriguing, the hypothesis remains to be tested.…”

Section: The Duration Of Therapy Biasmentioning

confidence: 99%

Helicobacter pylori diagnosis and therapy in the era of antimicrobial stewardship

Shiotani

Roy

Lü

et al. 2021

Therap Adv Gastroenterol

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The diagnosis and therapy of Helicobacter pylori infection have undergone major changes based on the use the principles of antimicrobial stewardship and increased availability of susceptibility profiling. H. pylori gastritis now recognized as an infectious disease, as such there is no placebo response allowing outcome to be assessed in relation to the theoretically obtainable cure rate of 100%. The recent recognition of H. pylori as an infectious disease has changed the focus to therapies optimized to reliably achieve high cure rates. Increasing antimicrobial resistance has also led to restriction of clarithromycin, levofloxacin, or metronidazole to susceptibility-based therapies. Covid-19 resulted in the almost universal availability of polymerase chain reaction testing in hospitals which can be repurposed to utilize readily available kits to provide rapid and inexpensive detection of clarithromycin resistance. In the United States, major diagnostic laboratories now offer H. pylori culture and susceptibility testing and American Molecular Laboratories offers next-generation sequencing susceptibility profiling of gastric biopsies or stools for the six commonly used antibiotics without need for endoscopy. Current treatment recommendations include (a) only use therapies that are reliably highly effective locally, (b) always perform a test-of-cure, and (c) use that data to confirm local effectiveness and share the results to inform the community regarding which therapies are effective and which are not. Empiric therapy should be restricted to those proven highly effective locally. The most common choices are 14-day bismuth quadruple therapy and rifabutin triple therapy. Prior guidelines and treatment recommendations should only be used if proven locally highly effective.

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Influence of clarithromycin on the bactericidal effect of amoxicillin in patients infected with clarithromycin-resistant strains of H. pylori

Cited by 9 publications

References 5 publications

Impact of body size on first‐line Helicobacter pylori eradication success using vonoprazan and amoxicillin dual therapy

Impact of body size on first‐line Helicobacter pylori eradication success using vonoprazan and amoxicillin dual therapy

Decline incidence in upper gastrointestinal bleeding in several recent years: data of the Japan claims database of 13 million accumulated patients

Helicobacter pylori diagnosis and therapy in the era of antimicrobial stewardship

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