N-acetylcysteine as an adjuvant therapy for Helicobacter pylori eradication

Fontes, Luis Eduardo Santos; Martimbianco, Ana Luiza Cabrera; Zanin, Carolina Gomide; Riera, Rachel

doi:10.1002/14651858.cd012357.pub2

Cited by 21 publications

(13 citation statements)

References 40 publications

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“…A combination of drugs, or increasing concentration, potentially results in a destructive effect, as mentioned in other studies [27,41]. The addition of a substance with an antibiofilm effect could be considered as adjuvant therapy, such as N-acetylcysteine, rhamnolipid, and lipid nanoparticle [46][47][48][49].…”

Section: Discussionmentioning

confidence: 93%

Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates

Fauzia

Miftahussurur

Syam

et al. 2020

Toxins

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We evaluated biofilm formation of clinical Helicobacter pylori isolates from Indonesia and its relation to antibiotic resistance. We determined the minimum inhibition concentration (MIC) of amoxicillin, clarithromycin, levofloxacin, metronidazole and tetracycline by the Etest to measure the planktonic susceptibility of 101 H. pylori strains. Biofilms were quantified by the crystal violet method. The minimum biofilm eradication concentration (MBEC) was obtained by measuring the survival of bacteria in a biofilm after exposure to antibiotics. The majority of the strains formed a biofilm (93.1% (94/101)), including weak (75.5%) and strong (24.5%) biofilm-formers. Planktonic resistant and sensitive strains produced relatively equal amounts of biofilms. The resistance proportion, shown by the MBEC measurement, was higher in the strong biofilm group for all antibiotics compared to the weak biofilm group, especially for clarithromycin (p = 0.002). Several cases showed sensitivity by the MIC measurement, but resistance according to the MBEC measurements (amoxicillin, 47.6%; tetracycline, 57.1%; clarithromycin, 19.0%; levofloxacin, 38.1%; and metronidazole 38.1%). Thus, biofilm formation may increase the survival of H. pylori and its resistance to antibiotics. Biofilm-related antibiotic resistance should be evaluated with antibiotic susceptibility.

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Section: Discussionmentioning

confidence: 93%

Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates

Fauzia

Miftahussurur

Syam

et al. 2020

Toxins

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“…However, as described in a systematic review, there is a lack of standards and details of the results of the few randomized clinical trials performed, which hinders the accuracy of information regarding the safety and efficacy of the applicability of NAC associated with the use of antibiotics in Helicobacter pylori -infected individuals [ 172 ]. Supporting the findings of this meta-analysis, a later study that aimed to assess the use of NAC associated with first-line triple therapy did not report an additive effect on the rate of eradication of the bacterium, when associated with the two therapeutic regimens [ 173 ].…”

Section: Clinical Indicationsmentioning

confidence: 99%

N-Acetylcysteine (NAC): Impacts on Human Health

et al. 2021

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N-acetylcysteine (NAC) is a medicine widely used to treat paracetamol overdose and as a mucolytic compound. It has a well-established safety profile, and its toxicity is uncommon and dependent on the route of administration and high dosages. Its remarkable antioxidant and anti-inflammatory capacity is the biochemical basis used to treat several diseases related to oxidative stress and inflammation. The primary role of NAC as an antioxidant stems from its ability to increase the intracellular concentration of glutathione (GSH), which is the most crucial biothiol responsible for cellular redox imbalance. As an anti-inflammatory compound, NAC can reduce levels of tumor necrosis factor-alpha (TNF-α) and interleukins (IL-6 and IL-1β) by suppressing the activity of nuclear factor kappa B (NF-κB). Despite NAC’s relevant therapeutic potential, in several experimental studies, its effectiveness in clinical trials, addressing different pathological conditions, is still limited. Thus, the purpose of this chapter is to provide an overview of the medicinal effects and applications of NAC to human health based on current therapeutic evidence.

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“…It is suggested that NAC may prevent gastritis induced by the organism [ 108 ]. In a Cochrane review, the evidence from most studies is weak; however, further studies are warranted [ 109 ].…”

Section: Infectious Diseasementioning

confidence: 99%

N-Acetylcysteine: A Review of Clinical Usefulness (an Old Drug with New Tricks)

Schwalfenberg

2021

Journal of Nutrition and Metabolism

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Objective. To review the clinical usefulness of N-acetylcysteine (NAC) as treatment or adjunctive therapy in a number of medical conditions. Use in Tylenol overdose, cystic fibrosis, and chronic obstructive lung disease has been well documented, but there is emerging evidence many other conditions would benefit from this safe, simple, and inexpensive intervention. Quality of Evidence. PubMed, several books, and conference proceedings were searched for articles on NAC and health conditions listed above reviewing supportive evidence. This study uses a traditional integrated review format, and clinically relevant information is assessed using the American Family Physician Evidence-Based Medicine Toolkit. A table summarizing the potential mechanisms of action for N-acetylcysteine in these conditions is presented. Main Message. N-acetylcysteine may be useful as an adjuvant in treating various medical conditions, especially chronic diseases. These conditions include polycystic ovary disease, male infertility, sleep apnea, acquired immune deficiency syndrome, influenza, parkinsonism, multiple sclerosis, peripheral neuropathy, stroke outcomes, diabetic neuropathy, Crohn’s disease, ulcerative colitis, schizophrenia, bipolar illness, and obsessive compulsive disorder; it can also be useful as a chelator for heavy metals and nanoparticles. There are also a number of other conditions that may show benefit; however, the evidence is not as robust. Conclusion. The use of N-acetylcysteine should be considered in a number of conditions as our population ages and levels of glutathione drop. Supplementation may contribute to reducing morbidity and mortality in some chronic conditions as outlined in the article.

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N-acetylcysteine as an adjuvant therapy for Helicobacter pylori eradication

Cited by 21 publications

References 40 publications

Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates

Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates

N-Acetylcysteine (NAC): Impacts on Human Health

N-Acetylcysteine: A Review of Clinical Usefulness (an Old Drug with New Tricks)

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