Management of Helicobacter pylori infection

Abstract

Helicobacter pylori infection exhibits a wide disease spectrum ranging from asymptomatic gastritis, peptic ulcer disease, to gastric cancer. H. pylori can induce dysbiosis of gastric microbiota in the pathway of carcinogenesis and successful eradication can restore gastric homeostasis. Diagnostic testing and treatment for H. pylori infection is recommended in patients with active or past history of peptic ulcer, chronic dyspepsia, chronic non-steroidal anti-inflammatory drugs (NSAID) or aspirin use, precancerous gastric lesions, gastric cancer, mucosa-associated lymphoid tissue (MALT) lymphoma, family history of gastric cancer, family history of peptic ulcers, household family member having active H. pylori infection, iron deficiency anemia, idiopathic thrombocytopenic purpura, or vitamin B12 deficiency. Recommended first-line regimens for H. pylori eradication are classified according to clarithromycin resistance. In areas of high clarithromycin resistance (≥15%), we recommend 14-day concomitant therapy or 14-day bismuth quadruple therapy (BQT) as first-line regimen. In areas of low clarithromycin resistance (<15%), we recommend 14-day triple therapy or 14-day BQT as first-line treatment. Second-line regimens are 14-day levofloxacin triple therapy or 14-day BQT if BQT is not previously used. For patients with multiple treatment failure, antimicrobial susceptibility testing (AST) should be performed. If AST is not available, we recommend using antibiotics not previously used or for which resistance is unlikely, such as amoxicillin, tetracycline, bismuth, or furazolidone. High-dose potent proton pump inhibitor or vonoprazan is recommended to achieve adequate acid suppression. Probiotics can be used as an adjuvant treatment to reduce the side effects of antibiotics and enhance eradication rate.

Gender determinism of the effect of placenta cryoextract on the hepatotropic effects of esomeprazole, clarithromycin and metronidazole in chronic liver damage

“…), Маастрихт-V (2022 р.)). Сучасні схеми антихелікобактерної терапії містять препарати вісмуту, інгібітори протонної помпи (ІПП) та комбінацію 2-3 антибактеріальних препаратів з переліку: амоксицилін, кларитроміцин, метронідазол, тетрациклін, левофлоксацин, рифабутин або фуразолідон [3,4,5]. Така варіативність схем лікування хелікобактеріозу обґрунтована прогресуючою антибіотикорезистентністю Helicobacter pylori, особливо до кларитроміцину та метронідазолу [4,5].…”

Pilot studies of vonoprazan‐containing Helicobacter pylori eradication therapy suggest Thailand may be more similar to the US than Japan

“…3 Recent study report that clarithromycin resistance in Thailand was higher than those in the United States, whereas a lower incidence of H. pylori infection in Thailand was reported compared with in Japan and the Unites States. 4 Current H. pylori eradication regimens emphasize the benefits of increased acid suppression 5 and have used the potassium competitive acid blocker (P-CAB), vonoprazan which has a higher potency, longer duration of acid suppression, and more rapid onset of action than conventional proton pump inhibitors (PPIs). [6][7][8] Cytochrome P450 (CYP), CYP2B6, CYP2C19, and CYP2D6 are involved in the metabolism of vonoprazan into inactive form with CPY3A4/5 being the main contributor.…”

The first Helicobacter pylori‐induced Guillain–Barré syndrome in Sudan

“…Helicobacter pylori is a widespread gram‐negative bacterium with a distinctive spiral shape that is responsible for causing serious chronic bacterial infections worldwide 6 . Helicobacter pylori infection has been identified as a major contributor to various health conditions such as chronic gastritis, peptic ulcers, gastric mucosa‐associated lymphoid tissue (MALT) lymphoma, and gastric adenocarcinoma.…”

“…Helicobacter pylori is a widespread gram-negative bacterium with a distinctive spiral shape that is responsible for causing serious chronic bacterial infections worldwide. 6 Helicobacter pylori infection has been identified as a major contributor to various health conditions such as chronic gastritis, peptic ulcers, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric adenocarcinoma. Unfortunately, in 2020 alone, there were over 1 million new cases of gastric cancer and nearly 800,000 deaths attributed to H. pylori-related diseases, making it the third leading cause of global cancer deaths.…”