Review: Second-line rescue therapy of <i>Helicobacter pylori</i> infection

Gisbert, Javier P.

doi:10.1177/1756283x09347109

Cited by 30 publications

(33 citation statements)

References 201 publications

(388 reference statements)

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“…LVX has recently been prescribed as a rescue drug to eradicate infection in patients with failed first-line therapy [29,30]. However, the incidence of LVX resistance seems to be increasing worldwide, which may reduce the efficacy of treatment with LVX-based regimens [31,32].…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori antibiotic susceptibility patterns in Bangladesh: Emerging levofloxacin resistance

Aftab

Miftahussurur

Subsomwong

et al. 2016

J Infect Dev Ctries

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Introduction: The most recent study to report Helicobacter pylori antibiotic resistance rates in Bangladesh was published 15 years ago and did not include levofloxacin. We therefore aimed to determine the current antibiotic susceptibility of H. pylori to amoxicillin, clarithromycin, metronidazole, tetracycline and levofloxacin in Bangladesh. Methodology: This study included 133 consecutive patients who underwent endoscopy examination at Dhaka Medical College in November 2014. The serial two-fold agar dilution method was used to determine the minimum inhibitory concentrations of the five antibiotics. Results: Among 56 cultured strains, H. pylori showed high rates of resistance to clarithromycin and metronidazole (39.3% and 94.6%, respectively). Moreover, levofloxacin showed an emerging antimicrobial resistance pattern (66.1%), which was higher in patients with gastritis than that in those with peptic ulcers (p = 0.02). The resistance rate of levofloxacin was significantly higher in patients living in Dhaka city compared to those living in the village (p = 0.049). However, amoxicillin and tetracycline resistance rates were very low. Resistance to both metronidazole and levofloxacin was most commonly observed. Conclusions: The rates of resistance to clarithromycin, metronidazole, and levofloxacin were high in Bangladesh, which suggests that triple therapy based on these drugs may not be useful as first-line therapies in Bangladesh. Alternative strategies such as furazolidone-based triple therapy, bismuth-based quadruple therapies, or sequential therapy may be more effective for patients in in Bangladesh.

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Section: Discussionmentioning

confidence: 99%

Helicobacter pylori antibiotic susceptibility patterns in Bangladesh: Emerging levofloxacin resistance

Aftab

Miftahussurur

Subsomwong

et al. 2016

J Infect Dev Ctries

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“…Recently, LVFX has been prescribed as a rescue drug to eradicate infection in patients with failure of first-line therapy 36, 37 . However, the incidence of LVFX resistance seems to be increasing worldwide, and this may reduce the efficacy of treatment with LVFX-based regimens 38–43 .…”

Section: Discussionmentioning

confidence: 99%

The Incidence of Primary Antibiotic Resistance of Helicobacter pylori in Vietnam

Binh

Shiota

Nguyen

et al. 2013

Journal of Clinical Gastroenterology

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Goals To determine the susceptibility of Helicobacter pylori strains isolated from a Vietnamese population to 5 antibiotics. Background The incidence of antibiotic resistance in H. pylori infection is increasing worldwide and has become a leading cause for failure of treatment. Antibiotic susceptibility testing is very important to provide optimal regimens in a clinical setting. Study We isolated 103 H. pylori strains from the gastric mucosa of H. pylori-infected patients from 2 areas in Vietnam (Ho Chi Minh and Hanoi) in 2008. Epsilometer test was used to determine the minimum inhibitory concentrations of amoxicillin (AMX), clarithromycin (CLR), metronidazole (MNZ), levofloxacin (LVFX), and tetracycline (TC). Results Among the 103 strains, the resistance rates were 0% (AMX), 33% (CLR), 69.9% (MNZ), 18.4% (LVFX), and 5.8% (TC). The resistant strains showed a high-level of resistance (≥256 μg/mL) to CLR, 23.5% (8/34), and MNZ, 29.1% (21/72). The resistance rate for CLR was significantly higher in Ho Chi Minh than in Hanoi (49% vs. 18.5%, P = 0.001). Resistance to both CLR and MNZ was most commonly observed (24.3%). Two strains (1.9%) were resistant to 4 of the 5 antibiotics. No significant association was observed between antibiotic resistance rates and age, gender, or clinical outcomes of the patients. Conclusions High incidence of resistance to CLR and MNZ suggests that standard triple therapies may not be useful as first-line treatment in Vietnam. Alternative strategies such as bismuth-based quadruple therapies or sequential therapy may be more effective in Vietnam.

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“…In general, combination of a quadruple regimen for metronidazole is still recommended for eradication of this pathogen in patients with gastroduodenal ulcers (43,44) and has been prescribed against H.pylori in Iran and other countries (45), but using metronidazole in our region, Isfahan can lead to eradication failure in clinical therapies due to having the highest rate of resistance. The antimicrobial agents prescribed in Isfahan against H. pylori by our gastroenterologists for first lines of treatment are amoxicillin, azithromycin, omeprazole and bismuth citrate and for second line of treatment are clarithromycin, tetracycline and furazolidone.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran

Mirzaei

Poursina

Faghri

et al. 2013

Jundishapur J Microbiol

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Background:Helicobacter pylori (H. pylori) is one of the most common infectious diseases in the world. It colonizes about 50-60% of the world's population. The estimated prevalence of H. pylori infection is approximately 65% in Iran. Objectives: The aim of the present study was to investigate the antimicrobial resistance of H. pylori to metronidazole, clarithromycin and amoxicillin. Materials and Methods: A total of 110 biopsy specimens were collected from patients with clinical symptoms of gastrointestinal disorders who were referred to the endoscopy unit at Al-Zahra Hospital, Isfahan, Iran. We investigated the frequency of H. pylori resistance to metronidazole, clarithromycin and amoxicillin among 48 positive isolates of H. pylori from the referred patients. After the culture of biopsy specimens and identification of H. pylori strains, susceptibility tests were done using the E test (epsilometer test) Results: The overall rates of resistance to metronidazole, clarithromycin and amoxicillin were 56.3%, 14.6% and 4.2% respectively. In our study, there was a significant correlation between resistance to metronidazole and gender (P < 0.05) but there was no significant correlation between resistance to amoxicillin and clarithromycin and gender (P ˃ 0.05). Conclusions: Information on antibiotic susceptibility profile plays an important role in empiric antibiotic treatment and management of refractive cases. With regards to this study, using metronidazole in the Isfahan region, can lead to eradication failure in clinical therapies due to having the highest rate of resistance but amoxicillin and clarithromycin are prescribed for first and second lines of treatment against H. pylori. Actually, susceptibility testing of H. pylori isolates in different geographical areas is advised because it aids the selection of optimal therapy regimens.

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Review: Second-line rescue therapy of Helicobacter pylori infection

Cited by 30 publications

References 201 publications

Helicobacter pylori antibiotic susceptibility patterns in Bangladesh: Emerging levofloxacin resistance

Helicobacter pylori antibiotic susceptibility patterns in Bangladesh: Emerging levofloxacin resistance

The Incidence of Primary Antibiotic Resistance of Helicobacter pylori in Vietnam

Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran

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