Triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies for <i>H pylori</i> eradication: A comparative three-armed randomized clinical trial

Seyed,; Amir, Muhammad; Mirbagheri,; Mehrdad,; Hasibi,; Mehdi,; Abouzari,; Armin,; Rashidi, Alimorad

doi:10.3748/wjg.12.4888

Cited by 13 publications

(25 citation statements)

References 6 publications

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“…The combination of ampicillin-sulbactum (ampicillin 225 mg and sulbactum 150 mg bid.) has equal or higher efficacy in quadruple therapy, so ampicillin-sulbactum can be considered in cases of amoxicillin resistant H. pylori strains [59].…”

Section: Standard Therapymentioning

confidence: 99%

Helicobacter pylori infection: A recent approach to diagnosis and management

Rana¹,

Wang²,

Li³

et al. 2017

J. Biomed

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Helicobacter pylori infection is the most common infection worldwide and is associated with simple dyspepsia, heartburn and peptic ulcer diseases, most commonly leading to upper gastrointestinal bleeding and, ultimately, to the severe complication of gastric malignancy. Ninety percent of duodenal ulcers and 70% of gastric ulcers are associated with helicobacter pylori infections. Noninvasive methods, such as the urea breath test (UBT-13C or 14C) and fecal antigen test (FAT), have high sensitivity and specificity for the diagnosis of H. pylori. However, 4-6 weeks of anti-secretary drugs (proton pump inhibitor) prior to testing can lead to false negative results. Invasive methods have benefits over noninvasive methods in the case of peptic ulcer diseases by taking samples for culture to determine their sensitivities and to stage disease progression to malignant transformation. Initially, standard triple regimen was the choice for treatment worldwide. However, high antibiotic resistances in various geographical regions have recently made standard quadruple therapy (bismuth-based) the preferred treatment. Recent studies have shown the promising benefits of 10-14 days of sequential and concomitant quadruple therapies as the first line option in high drug resistance areas, in cases of multidrug resistance or in prior treatment failure cases. Levofloxacin-based triple therapy, furazolidone-based regimens, and recent hybrid or rescue therapies are also beneficial towards the eradication of H. pylori infection as a second or third line therapy. Additionally, the use of probiotics and phytomedicines improve eradication rates when used with triple or quadruple therapies.

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Section: Standard Therapymentioning

confidence: 99%

Helicobacter pylori infection: A recent approach to diagnosis and management

Rana¹,

Wang²,

Li³

et al. 2017

J. Biomed

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“…Out of three 7-d regimens, 1 study showed acceptable eradication rates [19][20][21] . Also, out of three 10-d regimens, 2 were successful in achieving > 90% PP eradication rate [22][23][24] and out of three 14-d regimens, 1 yielded optimal results [25][26][27] .…”

Section: Standard Triple Therapymentioning

confidence: 99%

“…Out of nine 7-, 10-and 14-d Bismuth plus Metronidazole-containing quadruple regimens in Iran, none had acceptable eradication rates [20,22,26,[47][48][49][50][51][52] (Table 2). Besides, only one of the 9 studies conducted in Turkey had 90.1% PP eradication rate (Table 3) [30,[34][35][36][53][54][55][56][57] .…”

Section: Therapymentioning

confidence: 99%

Helicobacter pylorieradication in West Asia: A review

Fakheri

Bari

Aarabi

et al. 2014

WJG

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The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. However, no review article has yet evaluated and compared the efficacy of different regimens among different countries of this region. Therefore, we conducted a review to select the best options and provide recommendations for H. pylori treatment in this geographic region. A search through PubMed was carried out to obtain relevant randomized clinical trials published in English language up to June 2013. According to the results, among different therapeutic regimens used as the first-line protocols, 10-d Bismuth-Furazolidone/Metronidazole quadruple therapy, 14-d Clarithromycin-containing hybrid therapy and 14-d quadruple therapy including a proton pump inhibitor + Bismuth + Tetracycline (500 mg QID) + Metronidazole (500 mg TDS) seemed to be appropriate options. Among second-line therapeutic regimens, Bismuthbased quadruple therapies containing Tetracycline and Furazolidone/Metronidazole, triple therapy containing Amoxicillin and Gatifloxacin and Quadruple therapy including Bismuth + Azithromycin and Ofloxacin seemed to be effective options. Third-line therapies were not evaluated in West Asia; most guidelines, however, recommend choosing optimal eradication regimen according to the pattern of antibiotic susceptibility of H. pylori . Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same. Core tip: The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. The present study evaluates and compares the efficacy of different regimens among different countries of this region. Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same.

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“…The standard first-line therapy is a one week triple therapy amoxicillin, clarithromycin and a proton pump such as omeprazole, pantoprazole or rabeprazole, and the use of metronidazole instead of amoxycillin in those allergic to penicillin. 5,6 Resistance of H. pylori to metronidazole and macrolides has emerged worldwide and now constitutes a major problem in therapy. [7][8][9] This justifies the increasing use of culture in testing for H. pylori infection because it is the only diagnostic method that allows the susceptibility of this organism to antimicrobial agents to be assessed.…”

Section: Introductionmentioning

confidence: 99%

Cultural characteristics and antibiotic susceptibility pattern of Helicobacter Pylori isolated from dyspepsia patients

Adeniyi

Lawal

Otegbayo

et al. 2012

Gastroenterol Insights

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Helicobacter pylori consist in a helical shaped Gram-negative bacterium, approximately 3 micrometers long with a diameter of approximately 0.5 micrometers. It has 4-6 flagella. It is microaerophilic and tests positive for oxidase, catalase and urease. With its flagella, the bacterium moves through the stomach lumen and drills into the mucus gel layer of the stomach. In humans, H. pylori have been associated with peptic ulcers, chronic gastritis, duodenitis and stomach cancer. It is widely believed that in the absence of treatment, H. pylori infection, once established in its gastric niche, persists for life. The aim of this research is to study the cultural characteristics and antibiotic susceptibility pattern of H. pylori strains isolated from southwest Nigeria. The cultural characteristics and antibiotic susceptibility pattern of Helicobacter pylori strains isolated from gastric mucosal antral biopsy specimens collected from 43 of 52 dyspepsia patients in the University College Hospital Ibadan, Oyo State, Nigeria, were determined using standard microbiological methods for Helicobacter pylori isolation. The 43 isolates were subjected to 23 different antibiotics and each of the antibiotics demonstrated a variable degree of activity against the isolates. Among the antibiotics to which the organism was most susceptible are: ofloxacin (30 µg) 100% activity, ciprofloxacin (5 µg) 97.67% activity, gentamicin (120 µg) 95.35 activity, amikacin (30 µg), kanamycin (30 µg) and chloramphenicol (30 µg) each 90.70% activity, clarithromycin (15 µg) 93.02, while the less active antibiotics are: augmentin (30 µg) 23.26% active, amoxycillin (25 µg) and metronidazole (50 µg) each 27.91% active and clindamycin (2 mg) 30.23% active. From the result of the antibiotic susceptibility pattern of the strains of the organism, 95.35% of the total isolates are multi drug resistant. Resistance was developed to, among others, augmentin (30 µg), amoxycillin (25 µg), metronidazole (50 µg) and clindamycin (2 mg).

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Triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies for H pylori eradication: A comparative three-armed randomized clinical trial

Cited by 13 publications

References 6 publications

Helicobacter pylori infection: A recent approach to diagnosis and management

Helicobacter pylori infection: A recent approach to diagnosis and management

Helicobacter pylorieradication in West Asia: A review

Cultural characteristics and antibiotic susceptibility pattern of Helicobacter Pylori isolated from dyspepsia patients

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