Sequential versus Standard Triple Therapy for First-Line Helicobacter pylori Eradication: An Update

Nyssen, Olga P.; Martínez, Belén; Mégraud, Francis; Savarino, Vincenzo; Fallone, Carlo A.; Bazzoli, Franco; Gisbert, Javier P.

doi:10.3390/antibiotics13020136

Cited by 3 publications

(1 citation statement)

References 137 publications

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“…pylori treatment involves a combination of robust acid inhibitors with various combinations of antibiotics and/or bismuth. However, the frequency of antibiotic resistance in H. pylori has gradually increased over the past decades [7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Prospective Evaluation of a New Liquid-Type Rapid Urease Test Kit for Diagnosis of Helicobacter pylori

Kim,

Joo

et al. 2024

Diagnostics

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Background/Aims: Rapid and accurate diagnostic tools are essential for the timely recognition of Helicobacter pylori (H. pylori) in clinical practice. The rapid urease test (RUT) is a comparatively accurate and time-saving method recommended as a first-line diagnostic test. The primary objective of conducting the RUT is to obtain rapid results, thus enabling the initiation of an eradication therapy based on clarithromycin resistance testing. This study aimed to assess the reaction time and accuracy of a new liquid-type RUT. Method: In this prospective study, consecutive dyspeptic or check-up patients referred to our clinic for endoscopy were assessed to evaluate the rapidity and accuracy of a novel liquid-type RUT (Helicotest®, WON Medical, Bucheon, Republic of Korea) compared with another commercial RUT kit (HP kit, Chong Kun Dang, Seoul, Republic of Korea) and a real-time quantitative PCR-based assay (Seeplex® H.pylori-ClaR Detection, Seegene, Republic of Korea). RUTs were analyzed at 10 min, 30 min, 60 min, and 120 min. Results: Among the 177 enrolled patients, 38.6% were infected with H. pylori. The positivity rates of the liquid-type RUT were 26.1, 35.8, 39.2%, and 41.5% at 10, 30, 60, and 120 min, respectively. When compared with the HP kit test, the time needed to confirm positivity was significantly reduced by 28.6 min (95% CI, 16.60–39.73, p < 0.0001). Helicotest® had a greater accuracy (96.02 ± 1.47), sensitivity (98.53 ± 1.46) and NPV (99.03 ± 0.97) compared to the HP kit. Conclusions: Compared to the commonly used RUT, the new liquid-type RUT presented faster and reliable results. Such findings could improve H. pylori treatment outcomes, particularly in outpatient clinical settings.

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Section: Introductionmentioning

confidence: 99%

Prospective Evaluation of a New Liquid-Type Rapid Urease Test Kit for Diagnosis of Helicobacter pylori

Kim,

Joo

et al. 2024

Diagnostics

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Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Ranjan,

Neupane,

Maharjan

et al. 2024

Journal of Gastrointestinal Infections

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Background Helicobacter pylori eradication rates of the commonly used regimens vary among countries and even among different regions of the same country. We aimed to compare the eradication rate and safety of sequential therapy with levofloxacin-based triple therapy. Methods A comparative single-center study was conducted between October 2022 and November 2023 after obtaining ethical approval. Patients in group A received 14 days of levofloxacin-based triple therapy and those in group B received 14 days of sequential therapy. The eradication of H. pylori was assessed 4 weeks after the completion of the assigned regimens. The data regarding adverse events were also recorded. Results Among 150 patients (group A: 70, group B: 80) with mean age of 41.7 ± 15.0 years, 67 (44.6%) were male. The eradication was achieved in 65 (92.9%) in group A and 63 (78.8%) in group B, respectively (p = 0.01). All the patients in group A and 76 (95%) patients in group B had good compliance with medication. Adverse events were noticed in 7 (10%) in group A compared to 31 (38.7%) in group B (p < 0.001). The most common adverse events in group A and group B were drug-related diarrhea (3 [4.3%] vs. 11 [13.7%]), gastrointestinal intolerance (2 [2.8%] vs. 6 [7.5%]), and bad/metallic taste (1 [1.4%] vs. 22 [27.5%]). No serious adverse events were noted in both groups. Conclusion Sequential therapy is significantly less effective and has more nonserious adverse events compared to levofloxacin-based triple therapy in eradication of H. pylori.

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Genetic Determinants of Clarithromycin and Fluoroquinolones Resistance in Helicobacter pylori in Serbia

Kekic,

Jovicevic,

Kabic

et al. 2024

Antibiotics

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Background/Objectives: Stomach infections by Helicobacter pylori can cause acute or chronic gastritis, peptic ulcers, and gastric cancer. The rise in antibiotic resistance is a significant health issue highlighted by the World Health Organization. The increasing number of treatment failures underscores the necessity for antibiotic susceptibility testing (AST). The study aimed to investigate the current prevalence and resistance to fluoroquinolones and clarithromycin with their detected mutations. Methods: Stomach biopsies from symptomatic patients were subjected to molecular testing by GenoType Helico DR kit (Hain Lifescience GmbH, Nehren, Germany). Results: Positive findings on the presence of H. pylori were detected in 42.4% of symptomatic patients, with the significant majority of patients (69%) having previously failed treatments. The resistance rates to fluoroquinolones and clarithromycin were 53.9% and 58.5%, respectively, with significantly higher rates in secondary resistant strains. The main resistance markers in fluoroquinolones and clarithromycin were N87K (27.4%) and A2147G (78.6%), respectively. Hetero-resistance or mixed genotypes were detected in over 20% of tested patients. During the study period, a significant increase in trends in both fluoroquinolones and clarithromycin resistance rates was observed. Conclusions: Results indicate the need for the implementation of the latest Maastricht VI Consensus recommendations for both AST whenever possible and the use of tailored guided therapy options due to high resistance rates and possible treatment failures. The GenoType Helico DR kit is a useful tool for AST, especially in cases of mixed H. pylori genotypes.

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Sequential versus Standard Triple Therapy for First-Line Helicobacter pylori Eradication: An Update

Cited by 3 publications

References 137 publications

Prospective Evaluation of a New Liquid-Type Rapid Urease Test Kit for Diagnosis of Helicobacter pylori

Prospective Evaluation of a New Liquid-Type Rapid Urease Test Kit for Diagnosis of Helicobacter pylori

Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Genetic Determinants of Clarithromycin and Fluoroquinolones Resistance in Helicobacter pylori in Serbia

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