Seven-day genotypic resistance-guided triple Helicobacter pylori eradication therapy can be highly effective

Papastergiou, Vasilios; Mathou, Nicoletta; Licousi, Sophia; Evgenidi, A; Paraskeva, Konstantina; Giannakopoulos, Athanasios; Stavrou, Pinelopi-Zoi; Platsouka, E.; Karagiannis, John A.

doi:10.20524/aog.2017.0219

Cited by 14 publications

(16 citation statements)

References 39 publications

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“…Following tailored triple therapy, the pooled eradication rate was 97.8%. There was no significant difference in eradication rates between treatment‐naive and treatment‐experienced groups . This, however, is at odds with a Spanish study which found significantly higher eradication rates (83% vs 33%) in culture‐guided therapy in treatment‐naïve patients …”

Section: Culture‐guided Treatmentcontrasting

confidence: 57%

“…There was no significant difference in eradication rates between treatment-naive and treatmentexperienced groups. 61 This, however, is at odds with a Spanish study which found significantly higher eradication rates (83% vs 33%) in culture-guided therapy in treatment-naïve patients. 10 An Italian study comparing sequential and bismuth-based therapy did not find that the pattern of bacterial resistance significantly affected eradication rates.…”

Section: Culture-g U Ided Tre Atmentmentioning

confidence: 94%

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Treatment of Helicobacter pylori infection in 2018

et al. 2018

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Treatment options for the eradication of Helicobacter pylori continue to evolve. There have been many guidelines for H. pylori treatment published, which may lead to some confusion. However, most are in agreement with the most recent iteration of the Maastricht treatment guidelines. Triple therapy is still the most frequently used treatment, especially in areas of low clarithromycin resistance. Its best results are achieved when taken for a minimum of 10 days and with high-dose acid suppression. Quadruple therapy is gaining in popularity particularly in areas with increasing resistance to standard triple therapy. Whether three antibiotics, or bismuth and two antibiotics are used, excellent eradication rates are achieved, albeit with increased side effects. Levofloxacin second-line therapy is widely used; however bismuth, when available, is an increasingly successful option. Sequential therapy is challenging in terms of compliance and is no longer recommended. This past year witnessed a notable increase in the number of studies based on antimicrobial susceptibility testing and tailored eradication therapy, reflecting the role of culture-guided treatment, which may well represent the future of H. pylori treatment and prevent the inappropriate use of antibiotics.

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Section: Culture‐guided Treatmentcontrasting

confidence: 57%

Section: Culture-g U Ided Tre Atmentmentioning

confidence: 94%

Treatment of Helicobacter pylori infection in 2018

et al. 2018

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“…However, unlike other regimens, few studies have evaluated AST-based first-line regimens. The intention-to-treat (ITT) eradication rate for a first-line regimen is >90% [30][31][32]. In South Korea, a PCR-based first-line tailored therapy is superior to the standard triple therapy (STT; amoxicillin, clarithromycin, and PPI) [30,31].…”

Section: H Pylori Treatment Based On Ast Resultsmentioning

confidence: 99%

“…In South Korea, a PCR-based first-line tailored therapy is superior to the standard triple therapy (STT; amoxicillin, clarithromycin, and PPI) [30,31]. In a Greek study, genotypic resistance-guided triple therapy (clarithromycin and levofloxacin susceptibility testing by GenoType HelicoDR assay) has achieved a high H. pylori eradication rate (90.2% by ITT and 97.8% by per-protocol (PP) analyses) [32]. In addition, AST-guided first-line triple regimens result in a >90% eradication rate in patients with H. pylori resistant to two antibiotics [33].…”

Section: H Pylori Treatment Based On Ast Resultsmentioning

confidence: 99%

Best Helicobacter pylori Eradication Strategy in the Era of Antibiotic Resistance

Kim

Chung

2020

Antibiotics

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Antibiotic resistance is the major reason for Helicobacter pylori treatment failure, and the increasing frequency of antibiotic resistance is a challenge for clinicians. Resistance to clarithromycin and metronidazole is a particular problem. The standard triple therapy (proton pump inhibitor, amoxicillin, and clarithromycin) is no longer appropriate as the first-line treatment in most areas. Recent guidelines for the treatment of H. pylori infection recommend a quadruple regimen (bismuth or non-bismuth) as the first-line therapy. This treatment strategy is effective for areas with high resistance to clarithromycin or metronidazole, but the resistance rate inevitably increases as a result of prolonged therapy with multiple antibiotics. Novel potassium-competitive acid blocker-based therapy may be effective, but the data are limited. Tailored therapy based on antimicrobial susceptibility test results is ideal. This review discussed the current important regimens for H. pylori treatment and the optimum H. pylori eradication strategy.

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“…A few available studies gathered data on the potential of a PCR-tailored approach and found promising results [172,173]. Interestingly, a Greek pilot study [174] determined remarkably high cure rates using a tailored 7-day triple regimen, in which selection of the key antibiotic (clarithromycin, levofloxacin, or rifabutin) relied on a PCR-based reverse hybridization assay. In the future, both clinical and economic evaluation data are awaited to better characterize the position of molecular testing in routine practice [175,176].…”

Section: Recommendation Grade: C; Evidence Level: 4; Agreement Level:mentioning

confidence: 99%

Hellenic consensus on Helicobacter pylori infection

Georgopoulos

Michopoulos

Rokkas³

et al. 2020

aog

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The Hellenic Society of Gastroenterology recently organized the "Hellenic consensus on Helicobacter pylori (H. pylori) infection". The aim of this publication is to report the guidelines in order to aid the national gastroenterology community in the management of H. pylori infection. Forty-one delegates from all Greek regions, including gastroenterologists, pathologists, clinical microbiologists, epidemiologists and basic scientists, were invited to this meeting. The participants were allocated to 1 of the 4 main topics of the meeting: i.e., H. pylori diagnosis and association with diseases; H. pylori and gastric cancer; H. pylori and extragastric associated disorders; and H. pylori treatment. The results of each subgroup were submitted to a final consensus vote that included all participants. Relevant data based on international and Greek publications were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. The cutoff level of 70% was considered as acceptance for the final statement. It is hoped that the recommendations and conclusions of this report will guide Greek doctors in their daily practice concerning the management of H. pylori infection.

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Seven-day genotypic resistance-guided triple Helicobacter pylori eradication therapy can be highly effective

Cited by 14 publications

References 39 publications

Treatment of Helicobacter pylori infection in 2018

Treatment of Helicobacter pylori infection in 2018

Best Helicobacter pylori Eradication Strategy in the Era of Antibiotic Resistance

Hellenic consensus on Helicobacter pylori infection

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