Review: Clinical Management of <i>Helicobacter pylori</i> Infection in China

Xie, Chuan; Lü, Nonghua

doi:10.1111/hel.12178

Cited by 88 publications

(76 citation statements)

References 64 publications

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“…Here, our result is consistent with the current opinion that 7-day standard triple therapy is obsolete mainly due to clarithromycin resistance. 29,33,34 Since pretreatment susceptibility tests would help overcome antibiotic resistance, tailored therapy is superior to standard triple therapy in eradication rate. However, the advantage of tailored therapy is undermined when the duration of triple therapy is prolonged to 10 days.…”

Section: Discussionmentioning

confidence: 99%

Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication

et al. 2016

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Although various regimens are empirically accepted for Helicobacter pylori eradication, the efficacy might be declined by multiple individual factors. The necessity of a personalized eradication therapy still remains controversial. The aim of the study was to compare tailored therapy with empiric chosen regimens.Databases of PUBMED, EMBASE, and MEDLINE were searched for eligible studies, published up to October 2015. All relevant controlled clinical trials were included. A random-effect model was applied to compare pooled relative risk (RR) with related 95% confidence intervals (CIs).Thirteen controlled clinical trials integrating 3512 participants were assessed. Overall, the pooled eradication rates of tailored groups were higher than those of empiric ones (intention-to-treat: RR = 1.16, 95% CI 1.10–1.22; preprotocol: RR = 1.14, 95% CI 1.08–1.21). In subgroup analysis, tailored therapy was superior to 7-day standard triple therapy (RR = 1.22, 95% CI 1.16–1.29) and bismuth-quadruple therapy (RR = 1.14, 95% CI 1.07–1.22) on eradication rates; first-line tailored therapy achieved higher eradication rates than first-line empirical regimens (pooled RR = 1.18, 95%CI 1.14–1.22), whereas tailored rescue regimen showed no difference with empirical ones (pooled RR = 1.16, 95% CI 0.96–1.39). Moreover, among different tailored designs, susceptibility-guided tailored therapy obtained higher eradication rates than empiric groups, independent of CYP2C19 genotype detection (with CYP: RR = 1.16, 95% CI 1.09–1.23; without CYP: RR = 1.14, 95% CI 1.01–1.28). Both molecular test-based and culture-based tailored groups were better on eradication rates than empiric groups (molecular: RR = 1.23, 95% CI 1.11–1.35; culture: RR = 1.13, 95% CI 1.06–1.20).Compared with empiric chosen treatments, tailored therapy is a better alternative for H pylori eradication.

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Section: Discussionmentioning

confidence: 99%

Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication

et al. 2016

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“…Another survey of H. pylori infection in 51 025 people from 24 districts in China between 2005 and 2011 showed an overall infection rate of 49.5%; even in people younger than 20 years old, the infection rate is still as high as 37.1% . Although China has seen many improvements in the past 30 years in the detection and treatment of H. pylori , it is still an area with relatively high infection rates, especially in young people, as compared with other developed countries …”

Section: Helicobacter Pylori Infection and Gastric Cancermentioning

confidence: 99%

Consensus on eradication of Helicobacter pylori and prevention and control of gastric cancer in China (2019, Shanghai)

Liu

et al. 2020

J of Gastro and Hepatol

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Background and Aim China is a country with high prevalence of Helicobacter pylori (H. pylori) infection, which in turn is closely related to the occurrence of gastric cancer. Therefore, the risks of H. pylori infection and gastric cancer are highly overlapping, and the prevention and treatment of H. pylori infection are necessary to prevent gastric cancer. Methods Based on evidence‐based medicine and the Delphi method, the National Clinical Medical Research Center for Digestive Disease along with the National Early Gastrointestinal Cancer Prevention and Treatment Center Alliance organized dozens of experts in the fields of digestive diseases, H. pylori research, gastric cancer surgery, epidemiology, health economics, and health management to discuss the relationship between H. pylori eradication and prevention and the treatment of gastric cancer. Results A preliminary consensus on the relationship between H. pylori infection and gastric cancer, H. pylori eradication and gastric cancer prevention, and H. pylori screening and eradication strategy was reached. The consensus further clarified the relationship between H. pylori and gastric cancer and how to formulate future prevention and control strategies for gastric cancer. Conclusions This consensus could provide guidance on early detection, diagnosis, and treatment of H. pylori to reduce the occurrence of gastric cancer in China.

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“…The causes for this decline may involve patient compliance, bacterial factors, obesity, smoking, reinfection, and genetic polymorphisms in CYP2C19. However, antibiotic resistance may be the primary reason for reduced eradication of H. pylori infection worldwide [20][21][22] . In addition, the eradication rates differ by region, even in the same country.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic treatment forHelicobacter pylori: Is the end coming?

Kim

Choi

Chung

2015

WJGPT

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Infection with the Gram-negative pathogen Helicobacter pylori (H. pylori ) has been associated with gastroduodenal disease and the importance of H. pylori eradication is underscored by its designation as a group I carcinogen. The standard triple therapy consists of a proton pump inhibitor, amoxicillin and clarithromycin, although many other regimens are used, including quadruple, sequential and concomitant therapy regimens supplemented with metronidazole, clarithromycin and levofloxacin. Despite these efforts, current therapeutic regimens lack efficacy in eradication due to antibiotic resistance, drug compliance and antibiotic degradation by the acidic stomach environment. Core tip: This article reviews the recent literature describing antibiotic resistance and trends in Helicobacter pylori (H. pylori ) treatment. As there is no effective conventional therapy, new treatments are being developed and bismuth quadruple, sequential, concomitant therapies are recommended as a first-line regimen in regions with high levels of clarithromycin resistance. Quinolones have also been used for H. pylori treatment, although the cure rate has gradually reduced with this approach. New therapeutic directions include probiotic supplementation, tailored therapy, novel agents, and nanotechnology.

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Review: Clinical Management of Helicobacter pylori Infection in China

Cited by 88 publications

References 64 publications

Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication

Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication

Consensus on eradication of Helicobacter pylori and prevention and control of gastric cancer in China (2019, Shanghai)

Antibiotic treatment forHelicobacter pylori: Is the end coming?

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