Prevalence of Primary Antimicrobial Resistance of <i>H. pylori</i> in Turkey: A Systematic Review

Kocazeybek, Bekir; Tokman, Hrisi Bahar

doi:10.1111/hel.12272

Cited by 44 publications

(57 citation statements)

References 62 publications

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“…Most have used metronidazole 500 mg two times per day. In Iran and Turkey, antimicrobial resistance in general is common and both countries typically report low cure rates irrespective of the therapy offered (eg, various triple therapies, bismuth quadruple and the non-bismuth quadruple therapies) 1 3 44. High rates of antimicrobial resistance and even multidrug resistance have also been reported from both areas 13.…”

Section: Prior Experience With Triple Therapy Plus Bismuth Therapymentioning

confidence: 99%

Role of bismuth in improvingHelicobacter pylorieradication with triple therapy

Dore

Lü

Graham

2016

Gut

223

248

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In most regions of the world, antimicrobial resistance has increased to the point where empirical standard triple therapy for Helicobacter pylorieradication is no longer recommended. The treatment outcome in a population is calculated as the sum of the treatment success in the subpopulation with susceptible infections plus treatment success in the subpopulation with resistant infections. The addition of bismuth (i.e., 14-day triple therapy plus bismuth) can improve cure rates despite a high prevalence of antimicrobial resistance. The major bismuth effect is to add an additional 30%-40% to the success with resistant infections. The overall result is therefore dependent on the prevalence of resistance and the treatment success in the subpopulation with resistant infections (eg, with proton-pump inhibitor-amoxicillin dual therapy). Here, we explore the contribution of each component and the mechanisms of how bismuth might enhance the effectiveness of triple therapy. We also discuss the limitations of this approach and provide suggestions how triple therapy plus bismuth might be further improved.

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Section: Prior Experience With Triple Therapy Plus Bismuth Therapymentioning

confidence: 99%

Role of bismuth in improvingHelicobacter pylorieradication with triple therapy

Dore

Lü

Graham

2016

Gut

223

248

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“…The resistance rates to clarithromycin are high, varying from 16.4% in the United States, to 37.2% in Beijing, China, 7.7%-21.5% in Europe, 55.6% in Japan, and 12% in Latin America[8]. The clarithromycin resistance rate in Turkey was recently reported to equal 24.8%[32]. However, high clarithromycin resistance rates, including approximately 30% in Italy and Japan, approximately 40% in Turkey, and approximately 50% in China, were also reported in the current guideline[12].…”

Section: Antimicrobial Resistancementioning

confidence: 99%

“…In developed countries, metronidazole and related nitroimidazoles are frequently used for gynaecological infections, dental infections, and parasite-related diseases[29,34]. Although high metronidazole resistance rates are due to its common usage, the effect of high resistance on the eradication of H. pylori can be overcome by extending the duration time and increasing the administered dose[8,9,32]. …”

Section: Antimicrobial Resistancementioning

confidence: 99%

“…Primary rifabutin resistance was reported high in China (14.2%)[21] and Bulgaria (12%)[34] but low in Germany (1.4%) and England (6.6%)[30]. In Turkey, the overall resistance rates to clarithromycin, amoxicillin, metronidazole, tetracycline, and levofloxacin in H. pylori were reported in a systematic review to equal 24.9%, 1%, 33.7%, 3.5%, and 23.8%, respectively[32]. …”

Section: Antimicrobial Resistancementioning

confidence: 99%

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Importance of antimicrobial susceptibility testing for the management of eradication inHelicobacter pyloriinfection

Arslan

Yılmaz

Demiray-Gürbüz

2017

WJG

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The management of Helicobacter pylori (H. pylori) infection treatment differs from the common treatment protocol for other infectious diseases. Because culture- or molecular-guided approaches face several practical issues, such as the invasive procedures required to obtain gastric biopsy specimens and the lack of availability of routine laboratory testing in some places, H. pylori treatment includes the administration of two or three empirically selected antibiotics combined with a proton pump inhibitor rather than evidence-based eradication treatment. The efficacy of empirical therapy is decreasing, mostly due to increasing multiple resistance. Multiresistance to levofloxacin, clarithromycin, and metronidazole, which are commonly used in empirical treatments, appears to have increased in many countries. Mutations play a primary role in the antimicrobial resistance of H. pylori, but many different mechanisms can be involved in the development of antibiotic resistance. Determining and understanding these possible mechanisms might allow the development of new methods for the detection of H. pylori and the determination of antimicrobial resistance. A treatment based on the detection of antimicrobial resistance is usually more effective than empirical treatment. Nevertheless, such an approach before treatment is still not recommended in the Maastricht guidelines due to the difficulty associated with the routine application of available culture- or molecular-based susceptibility tests, which are usually administered in cases of treatment failure. The management of first and rescue treatments requires further research due to the steadily increase in antimicrobial resistance.

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“…Based on the recent systematic review of the prevalence (from 1999 to 2015) of primary antibiotic resistance of H. pylori strains in different geographical regions of Turkey, the overall primary antibiotic resistance rates of H. pylori strains were as follows: amoxicillin 0.971%, clarithromycin 24.864%, metronidazole 33.747%, tetracycline 3.511%, and levofloxacin 23.769%. There was an increase in primary resistance rates to clarithromycin and metronidazole in different years [11].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Helicobacter pylori Eradication Rates of 2-Week Levofloxacin-Containing Triple Therapy, Levofloxacin-Containing Bismuth Quadruple Therapy, and Standard Bismuth Quadruple Therapy as a First-Line Regimen

et al. 2017

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i.d, levofloxacin 500 mg, once daily). The primary outcome was the eradication rate in the intention-to-treat (ITT) and per protocol (PP) analysis. Results: The eradication rates of the above 3 groups using ITT analysis were RBAL 83.8%, RBMT 88.3%, and RAL 74.8% compared with 91.2, 92.5, and 79.2%, respectively, using PP analysis. The eradication rate using RBMT was significantly higher than that of RAL (p = 0.029 in ITT analysis and p = 0.017 in PP analysis). Several side effects occurred in 156 patients (54.1%) KeywordsHelicobacter pylori infection · Bismuth-containing quadruple therapy · Levofloxacin-containing triple therapy · Eradication rate Abstract Objective: The aim of this study was to compare the efficacy and safety of 2-week levofloxacin-containing triple therapy, levofloxacin-containing bismuth quadruple therapy, and standard bismuth-containing quadruple therapy as a firstline regimen for the eradication of Helicobacter pylori. Methods: A total of 329 patients with H. pylori infection were randomly divided into 3 groups to receive one of the following regimens: (a) levofloxacin-containing bismuth quadruple Significance of the Study• This study compared the efficacy of 3 Helicobacter pylori eradication regimens, 2 of which contained levofloxacin, as the first line of treatment. Both quadruple regimens (standard bismuth quadruple therapy or levofloxacin-containing bismuth quadruple therapy) were highly effective in eradicating the infection and significantly superior to levofloxacin-containing triple therapy. Quadruple therapies should be used as first-line therapy for H. pylori infection.

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Prevalence of Primary Antimicrobial Resistance of H. pylori in Turkey: A Systematic Review

Cited by 44 publications

References 62 publications

Role of bismuth in improvingHelicobacter pylorieradication with triple therapy

Role of bismuth in improvingHelicobacter pylorieradication with triple therapy

Importance of antimicrobial susceptibility testing for the management of eradication inHelicobacter pyloriinfection

Comparison of Helicobacter pylori Eradication Rates of 2-Week Levofloxacin-Containing Triple Therapy, Levofloxacin-Containing Bismuth Quadruple Therapy, and Standard Bismuth Quadruple Therapy as a First-Line Regimen

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