Sequential Therapy for First-Line Helicobacter pylori Eradication: 10- or 14-Day Regimen?

Zullo, Angelo; Fiorini, Giulia; Scaccianoce, Giuseppe; Portincasa, Piero; Francesco, Vincenzo De; Vassallo, Roberto; Urban, F; Monica, Fabio; Mogavero, Giuseppe; Amato, Arnaldo; Vaira, Dino

doi:10.15403/jgld.2014.1121.281.hpy

Cited by 13 publications

(10 citation statements)

References 27 publications

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“…The UBT is one of the major non-invasive diagnostic tools for detection of H. pylori infection. The test is used worldwide, is totally non-invasive and can be used in children and pregnant women as well, with millions of subjects screened every year, both at a naïve level and after eradication therapies [4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

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Faster Detection of Helicobacter pylori Infection by 13 C-Urea Breath Test. Comparing Short versus Standard Sampling Time

Molina-Molina

Bonfrate

Lorusso

et al. 2019

JGLD

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Background & Aims: 13 C-Urea Breath Test (UBT) is a non-invasive, highly accurate and recommended test to detect Helicobacter pylori (H. pylori) infection and to confirm post-therapy eradication. However, differences exist in terms of manufacturers, dose of labelled urea, addition of citric acid, solid vs. liquid formulation, and sampling times of breath samples. In this study, we compared the diagnostic accuracy of “short” (15 minutes) vs. “standard” (30 minutes) time for a single type of liquid UBT. Methods: We compared the performance of a single UBT type (BREATHQUALITY, AB Analitica, Padua, Italy, 10 mL of 75 mg 13 C-Urea and 1.4 g citric acid) during a “short” vs. “standard” breath sampling time. Enrolled were 151 subjects requiring UBT as naïve (N=92) or post-eradication (N=59) checks. Results: UBT at 15 and 30 minutes were highly comparable, showing optimal correlation in all subsets of patients (i.e. naïve vs. post eradication, negative vs. post eradication check). One discrepant result occurred at the borderline zone of the DOB 4‰, but proved to be true positive at a later confirmation by a second UBT and stool antigen test. Conclusions: By shortening the testing time of BREATHQUALITY to 15 minutes (-50%) comparable accuracy will be maintained and in addition, it will bring some benefits to patients’ waiting lists, compliance, and hospital staff.

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Section: Discussionmentioning

confidence: 99%

“…We incorporated the diagnosis of UBT in different settings looking at the impact of H. pylori infection in Italy, and outcome of different eradication therapies [5][6][7][8]. Patients J Gastrointestin Liver Dis, June 2019 Vol.…”

Section: Introductionmentioning

confidence: 99%

Faster Detection of Helicobacter pylori Infection by 13 C-Urea Breath Test. Comparing Short versus Standard Sampling Time

Molina-Molina

Bonfrate

Lorusso

et al. 2019

JGLD

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“…The standard 10-day sequential therapy was used 10 studies (34)(35)(36)(37)(38)(39)(40)(41)(42)(43), with an overall cure rate of 88.3% (3031/3431, 95% CI: 87.2-89.4). In a single study (38), a 14-day regimen were tested, achieving an eradication rate of 90.3% (131/145, 95% CI: 85.5-95.1).…”

Section: Sequential Therapymentioning

confidence: 99%

First-line therapies for H. pylori infection in Italy: a pooled-data analysis

Francesco¹,

Zullo²,

Manta³

et al. 2022

AGEB

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Background: Curing H. pylori infection remains challenging, and the use of most effective first-line therapy represents a therapeutic cornerstone. To monitor the efficacy of first-line therapies in Italy, we designed a systematic review with pooled- data analysis of data published in the last 15 years. Methods: The search was focused on standard regimens and adult patients. Studies that included modified therapy regimens, pediatric patients, case series with less than 5 patients, and those in language other than English were excluded. Results: A total of 40 studies, with 74 therapeutic arms and 13,539 patients were evaluated. Among the 14-day triple therapies, the combination with proton pump inhibitor (PPI), clarithromycin and amoxicillin achieved the highest (77.9%) success rate, whilst the lowest success rate (62.7%) was observed following the 14-day PPI, clarithromycin and tinidazole regimen. The overall efficacy of triple therapies significantly decreased from 75.7% to 72.1% in the last decade. Sequential (88.3% on 3431 patients), concomitant (88.8% on 376 patients), and the bismuth-based quadruple therapy with three-in-one capsule, containing bismuth subcitrate potassium (140 mg), metronidazole (125 mg), tetracycline (125 mg) (90.4% on 999 patients) achieved similarly high eradication rates, but data on concomitant are still limited. The bismuth-based was associated with the higher (38.7%) incidence of side-effects. Conclusions: Data found that all triple therapies, irrespective of drug combination and therapy duration, should be abandoned in Italy due to their unacceptable low success rates. Monitoring the efficacy of standard first-line therapies in other countries could be clinically useful for both patients and clinicians.

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“…12 In contrast, Group-B was given the Clarithromycin-based sequential therapy (Omeprazole+ Amoxicillin for five days and then Omeprazole+ Metronidazole+ Clarithromycin for the next five days) for eradication of H pylori. 13 Stool for H pylori antigen was performed at the end of therapy for each patient and based on presence or absence of stool antigen patients were labelled as with successful eradication or not. In addition, the type of therapy used and other socio-demographic factors were com-pared in the patients with the eradication of H pylori and those without successful eradication and persis-tent positive stool antigen even after the treatment.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Sequential and Concomitant Therapy for Eradication of Helicobacter Pylori

Shabbir

Nisar

Ashraf

et al. 2022

PAFMJ

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Objective: To compare the effectiveness of sequential and concomitant therapy for the eradication of Helicobacter pylori. Study Design: Quasi-experimental study. Setting and Duration of Study: Department of Gastroenterology and Medicine, Pak Emirates Military Hospital, Rawalpindi Pakistan from Jun to Sep 2021. Methodology: A total of 105 patients who were H-pylori positive on stool antigen tests and had to undergo eradication therapy were included in the study. Patients were randomized into Groups by lottery method. Group-A was given the Clarithromycin concomitant therapy (Omeprazole+ Amoxicillin+ Clarithromycin+ Metronidazole) for 10-14 days, while Group-B was given the Clarithromycin based sequential therapy (Omeprazole+ Amoxicillin for five days and then Omeprazole+ metronidazole+ Clarithromycin for next five days) for eradication of H pylori. A stool antigen test was done to determine the successful eradication in both Groups. Results: Out of 105 H pylori antigen-positive patients included in the study, 69(65.7%) had successful eradication of stool antigen while 36(34.3%) had stool antigen positive even after adequate treatment. The mean age of the study participants was 39.53±7.647 years. Eradication of H pylori in the study population was statistically significantly found in patients with age less than 40 years (p-value-0.033) and those who were taking sequential therapy as compared to concomitant therapy (pvalue<0.001). Conclusion: H-pylori eradication was achieved in most of the patients taking treatment. However, in our study, patients younger than 40 and those taking sequential therapy had more chances of successfully eradicating this bacteria invading the gastric mucosa than patients taking concomitant therapy.

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Sequential Therapy for First-Line Helicobacter pylori Eradication: 10- or 14-Day Regimen?

Cited by 13 publications

References 27 publications

Faster Detection of Helicobacter pylori Infection by 13 C-Urea Breath Test. Comparing Short versus Standard Sampling Time

Faster Detection of Helicobacter pylori Infection by 13 C-Urea Breath Test. Comparing Short versus Standard Sampling Time

First-line therapies for H. pylori infection in Italy: a pooled-data analysis

Comparison of Sequential and Concomitant Therapy for Eradication of Helicobacter Pylori

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