Worldwide and Regional Efficacy Estimates of First-line Helicobacter pylori Treatments

Zamani, Mohammad; Alizadeh-Tabari, Shaghayegh; Zamani, Vahid; Shokri‐Shirvani, Javad; Derakhshan, Mohammad H.

doi:10.1097/mcg.0000000000001641

Cited by 19 publications

(21 citation statements)

References 24 publications

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“…The efficacy of prolonged treatment duration has been well-known in the treatment of H. pylori infection using PPI-based regimens, including the triple therapy. 5,13,14 The findings of our study were consistent with studies on PPI-based regimens. Additionally, the 14-day tegoprazan-based treatment showed similar adverse events as the 7-day tegoprazan-based treatment.…”

Section: Discussionsupporting

confidence: 90%

“…This finding supports the beneficial effects of prolonged treatment duration in P‐CAB‐based eradication regimens. The efficacy of prolonged treatment duration has been well‐known in the treatment of H. pylori infection using PPI‐based regimens, including the triple therapy 5,13,14 . The findings of our study were consistent with studies on PPI‐based regimens.…”

Section: Discussionsupporting

confidence: 89%

“…H. pylori infection was assessed using one or more of the following tests: rapid urease test, 13 C-urea breath test (Korea Otsuka Pharmaceutical Co., Ltd., Seoul, Korea), and histological evaluation with modified Giemsa staining. H. pylori eradication therapy was considered to have failed if any of the above three tests were positive.…”

Section: Methodsmentioning

confidence: 99%

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7‐day versus 14‐day tegoprazan‐based triple therapy to treat Helicobacter pylori infection: Real‐world evidence

Jung

Kim

et al. 2022

J of Gastro and Hepatol

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Background and Aim: Potassium-competitive acid blockers (P-CABs) can be used to eradicate Helicobacter pylori infection. We aimed to evaluate the impact of treatment duration (7 vs 14 days) on successful H. pylori eradication with P-CAB-based triple therapy in Korea, where clarithromycin resistance rate is high. Methods: We retrospectively reviewed the data of patients who received first-line treatment for H. pylori infection with tegoprazan-based triple therapy (50 mg tegoprazan + 1000 mg amoxicillin + 500 mg clarithromycin twice daily for 1 or 2 weeks). The primary endpoint was the eradication rate in intention-to-treat (ITT) analysis. Results: Of the 948 patients included in the study, 435 and 513 received 7-day and 14-day tegoprazan-based triple therapy, respectively. The eradication rate was higher in the 14-day therapy group than in the 7-day therapy group (ITT, 63.9%; 95% confidence interval [CI], 59.3-68.3%] vs 78.6% [95% CI, 74.9-81.9%], respectively, P < 0.001; per-protocol, 70.5% [95% CI, 65.8-74.8%] vs 85.1% [81.7-88.1%], respectively, P < 0.001). Overall adverse event rates did not differ between the two groups. Although six patients in the 14-day treatment group discontinued the prescribed medications due to adverse events, four of them (67%) discontinued the medication within 4 days. Conclusions: The 14-day tegoprazan-based triple therapy showed a superior eradication rate and acceptable adverse events compared with the 7-day tegoprazan-based triple therapy. A 14-day treatment regimen may be required when H. pylori infection is treated with tegoprazan-based triple therapy in regions with high clarithromycin resistance.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

7‐day versus 14‐day tegoprazan‐based triple therapy to treat Helicobacter pylori infection: Real‐world evidence

Jung

Kim

et al. 2022

J of Gastro and Hepatol

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“…To this point, there has been insufficient surveillance data to consistently identify locally effective regimens [20]. Notably, data on antibiotic resistance among H. pylori strains in North America remain particularly scarce [21]. When local antibiotic resistance patterns are unknown, guidelines recommend bismuth-based or non-bismuthbased quadruple therapies as empiric first-line regimens [17].…”

Section: Introductionmentioning

confidence: 99%

Clinical Factors Implicated in Antibiotic Resistance in Helicobacter pylori Patients

et al. 2022

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Helicobacter pylori is a common gastric pathogen associated with multiple clinical syndromes, including cancer. Eradication rates of H. pylori remain suboptimal despite the progress made in the past few decades in improving treatment strategies. The low eradication rates are mainly driven by antibiotic resistance of H. pylori. Non-invasive molecular testing to identify patients with antibiotic-resistant H. pylori represents a promising therapeutic avenue, however this technology currently remains limited by availability, costs, and lack of robust validation. Moreover, there is insufficient evidence to demonstrate that resistance-testing-based treatment approaches are superior to appropriately designed empiric strategies. Consensus guidelines recommend use of proven locally effective regimens; however, eradication data are inconsistently generated in several regions of the world. In this review, we describe several clinical factors associated with increased rates of antibiotic resistant H. pylori, including history of previous antibiotic exposure, increasing age, female gender, ethnicity/race, extent of alcohol use, and non-ulcer dyspepsia. Assessment of these factors may aid the clinician in choosing the most appropriate empiric treatment strategy for each patient. Future study should aim to identify locally effective therapies and further explore the clinical factors associated with antibiotic resistance.

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“…Classic therapeutic regimens for H. pylori eradication include the use of two antibiotics that are still widely used as the first-line treatment against H. pylori infection. 9 In China, amoxicillin, levofloxacin, furazolidone, and clarithromycin are the most frequently used antibiotics constituting these regimens. 10,11 The process of antibiotic resistance of H. pylori is evolving and dynamic.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic resistance status of helicobacter pylori strains isolated from initial eradication patients in Ningbo, China, from 2017 to 2021

et al. 2022

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Background Resistance of Helicobacter pylori (H. pylori) to antibiotics is an evolving and dynamic process. Presence of antibiotic resistance impacts the success rate of initial eradication strategies in the clinic. Aim To improve the success rate of initial eradication therapy and explore new antibiotic regimens, a large sample‐based study utilizing antimicrobial susceptibility testing was performed. A total of 2508 H. pylori strains from patients subjected to initial eradication therapy were isolated, cultured, and tested for drug susceptibility from 2017 to 2021. The minimal inhibitory concentration (MIC) was recorded. H. pylori susceptibility profiles and its change trends from initial eradication patients were analyzed. The relationships between drug resistance, year of sample collection, age, and sex of patients were analyzed. Results The overall resistance rates were as follows: amoxicillin (9.25%), clarithromycin (38.48%), levofloxacin (42.86%), furazolidone (11.28%), doxycycline (8.56%), rifampicin (10.81%), tinidazole (74.32%), gatifloxacin (61.71%), tetracycline (0%), metronidazole (78.71%), ornidazole (97.87%), and fosfomycin (31.67%). Only 38.04% of the strains were pansusceptible to amoxicillin, clarithromycin, levofloxacin, and furazolidone, followed by those of mono resistance (29.90%), double resistance (24.96%), triple resistance (6.34%), and quadruple resistance (0.76%). Significant differences in the resistance rate and MIC were also observed in different age and sex groups. Time of collection and patient age and sex were associated with the distribution of antibiotic resistance. Conclusion With the increasing resistance rate and multiple resistance of H. pylori to commonly used antibiotics, drug susceptibility testing is imperative to permit individualized therapy, and a regimen containing the combination of amoxicillin, furazolidone, tetracycline, doxycycline, or rifampicin is reasonable for initial empirical eradication therapy.

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Worldwide and Regional Efficacy Estimates of First-line Helicobacter pylori Treatments

Cited by 19 publications

References 24 publications

7‐day versus 14‐day tegoprazan‐based triple therapy to treat Helicobacter pylori infection: Real‐world evidence

7‐day versus 14‐day tegoprazan‐based triple therapy to treat Helicobacter pylori infection: Real‐world evidence

Clinical Factors Implicated in Antibiotic Resistance in Helicobacter pylori Patients

Antibiotic resistance status of helicobacter pylori strains isolated from initial eradication patients in Ningbo, China, from 2017 to 2021

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