One-week once-daily triple therapy with esomeprazole, levofloxacin and azithromycin compared to a standard therapy for Helicobacter pylori eradication

Iacopini, Federico; Crispino, Pietro; Paoluzi, O.A.; Consolazio, A.; Pica, Roberta; Rivera, M.; Palladini, Dino; Nardi, Francesco; Paoluzi, P.

doi:10.1016/j.dld.2005.03.007

Cited by 29 publications

(21 citation statements)

References 46 publications

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“…Amoxicillin (amoxicilline) with either clarithromycin or metronidazole is often the antibiotic combination of choice as a first-or second-line treatment regimen, respectively. However, in recent years the efficacy of the standard first-line triple therapy has also been decreasing dramatically, mainly due to development of resistance to the drugs (35,59). Failure to cure H. pylori infection has been noted for more than 20 to 30% of patients (37).…”

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confidence: 99%

In Vitro Antibacterial Activity of Acyl-Lysyl Oligomers againstHelicobacter pylori

Makobongo

Kovachi

Gancz

et al. 2009

Antimicrob Agents Chemother

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The gastric pathogen Helicobacter pylori has developed resistance to virtually all current antibiotics; thus, there is a pressing need to develop new anti-H. pylori therapies. The goal of this work was to evaluate the antibacterial effect of oligo-acyl-lysyl (OAK) antimicrobial peptidomimetics to determine if they might represent alternatives to conventional antibiotic treatment of H. pylori infection. A total of five OAK sequences were screened for growthinhibitory and/or bactericidal effects against H. pylori strain G27; four of these sequences had growth-inhibitory and bactericidal effects. The peptide with the highest efficacy against strain G27, C 12 K-2␤ 12 , was selected for further characterization against five additional H. pylori strains (26695, J99, 7.13, SS1, and HPAG1). C 12 K-2␤ 12 displayed MIC and minimum bactericidal concentration (MBC) ranges of 6.5 to 26 M and 14.5 to 90 M, respectively, across the six strains after 24 h of exposure. G27 was the most sensitive H. pylori strain (MIC ‫؍‬ 6.5 to 7 M; MBC ‫؍‬ 15 to 20 M), whereas 26695 was the least susceptible strain (MIC ‫؍‬ 25 to 26 M; MBC ‫؍‬ 70 to 90 M). H. pylori was completely killed after 6 to 8 h of incubation in liquid cultures containing two times the MBC of C 12 K-2␤ 12 . The OAK demonstrated strong in vitro stability, since efficacy was maintained after incubation at extreme temperatures (4°C, 37°C, 42°C, 50°C, 55°C, 60°C, and 95°C) and at low pH, although reduced killing kinetics were observed at pH 4.5. Additionally, upon transient exposure to the bacteria, C 12 K-2␤ 12 showed irreversible and significant antibacterial effects and was also nonhemolytic. Our results show a significant in vitro effect of C 12 K-2␤ 12 against H. pylori and suggest that OAKs may be a valuable resource for the treatment of H. pylori infection.Helicobacter pylori is a microaerophilic gram-negative bacterium that colonizes the gastric mucosa. It is known to be a principal gastric pathogen of humans and is associated with the development of gastritis, gastric ulcers, duodenal ulcers, and gastric cancer (46,55,56,60). Approximately half of the world's population is infected with H. pylori (79). Thus, the bacterium poses a significant public health problem, which is further compounded by the fact that H. pylori has developed antimicrobial resistance to virtually all current antibiotics, a phenomenon that is hampering efforts to treat the infection (40, 51).Since the original isolation of H. pylori in the early 1980s, treatment of the bacterial infection has undergone a significant evolutionary development from initial monotherapy to dual, triple, and in more recent trials quadruple therapy (8, 18). Current treatment strategies employ combination therapy, since single-antibiotic therapy often results in failure to eradicate the infection (21). The highest H. pylori eradication rates have been reported with triple therapy, which involves the utilization of two antibiotics in combination with bismuth or a proton pump inhibitor, PPI (34,44). Amoxicillin (amoxicil...

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mentioning

confidence: 99%

In Vitro Antibacterial Activity of Acyl-Lysyl Oligomers againstHelicobacter pylori

Makobongo

Kovachi

Gancz

et al. 2009

Antimicrob Agents Chemother

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“…Chen et al [29] , Chen et al [28] , Iacopini et al [26] , Chen et al [29] , 2002 1 24 0 23 3.2 3.00 (0.12, 77.47)…”

Section: Discussionmentioning

confidence: 99%

“…Chen et al [28] , Iacopini et al [26] , Cammarota et al [37] , 1996 1 33 5 34 24.8 0.18 (0.02, 1.64)…”

Section: Discussionmentioning

confidence: 99%

“…There was no significant difference between the long-course and short-course subgroups; the summary ORs were 0.89 (95% CI: 0. Chen et al [28] , Iacopini et al [26] , Kang et al [25] , Kang et al [25] Iacopini et al [26] , Zhao et al [27] Chen et al [28] Chen et al [29] Vcev et al [32] , Laine et al [33] , …”

Section: Sub-analysesmentioning

confidence: 99%

“…Furthermore, we identified four additional articles from the Chinese Biomedical Database (1981 to May 2009). Finally, 14 RCTs met the inclusion criteria [24][25][26][27][28][29][30][31][32][33][34][35][36][37] . The flowchart of reviews showed the detailed process of selection ( Figure 1).…”

Section: Description Of the Studiesmentioning

confidence: 99%

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Azithromycin-containing versus standard triple therapy forHelicobacter pylori eradication: A meta-analysis

Dong

Yu²,

Zou³

2009

WJG

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AIM:To evaluate whether adding azithromycin to firstline Helicobacter pylori (H pylori ) eradication improved eradication and reduced side effects. METHODS:Eligible articles were identified by searches of electronic databases. We included all randomized trials that compared azithromycin-containing with standard triple-therapy regimens for first-line treatment of H pylori infection. Statistical analysis was performed with Review Manager 5.0.10. Sub-analyses were also performed. RESULTS:We identified 14 randomized trials (1431 patients). Pooled H pylori eradication rates were 72.01% (95% CI: 58.09%-85.93%) and 69.78% (95% CI: 66.47%-73.09%) for patients with or without azithromycin by intention-to-treat analysis, and the odds ratio (OR) was 1.17 (95% CI: 0.64-2.14). The occurrence of side effects differed significantly and was 15.81% (95% CI: 12.50%-19.12%) and 25.20% (95% CI: 21.44%-28.96%) for treatment with or without azithromycin, respectively, and the summary OR was 0.58 (95% CI: 0.41-0.82). Furthermore, the azithromycin-containing group had a lower occurrence of diarrhea, nausea and taste disturbance. CONCLUSION:Our review suggests that azithromycincontaining triple-therapy regimens could be equally effective in eradication of H pylori compared with standard first-line triple-therapy regimens.

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Ulcer Disease andHelicobacter pyloriInfection: Etiology and Treatment

Chiba

2010

Evidence‐Based Gastroenterology and Hepatology

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One-week once-daily triple therapy with esomeprazole, levofloxacin and azithromycin compared to a standard therapy for Helicobacter pylori eradication

Cited by 29 publications

References 46 publications

In Vitro Antibacterial Activity of Acyl-Lysyl Oligomers againstHelicobacter pylori

In Vitro Antibacterial Activity of Acyl-Lysyl Oligomers againstHelicobacter pylori

Azithromycin-containing versus standard triple therapy forHelicobacter pylori eradication: A meta-analysis

Ulcer Disease andHelicobacter pyloriInfection: Etiology and Treatment

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