TY - JOUR
T1 - Effectiveness of Helicobacter pylori Treatments According to Antibiotic Resistance
AU - Bujanda, Luis
AU - Nyssen, Olga P.
AU - Ramos, June
AU - Bordin, Dmitry S.
AU - Tepes, Bojan
AU - Perez-Aisa, Angeles
AU - Pavoni, Matteo
AU - Castro-Fernandez, Manuel
AU - Lerang, Frode
AU - Leja, Mārcis
AU - Rodrigo, Luis
AU - Rokkas, Theodore
AU - Kupcinskas, Juozas
AU - Jonaitis, Laimas
AU - Shvets, Oleg
AU - Gasbarrini, Antonio
AU - Simsek, Halis
AU - Phull, Perminder S.
AU - Buzás, György Miklós
AU - Machado, Jose C.
AU - Boltin, Doron
AU - Boyanova, Lyudmila
AU - Tonkić, Ante
AU - Marlicz, Wojciech
AU - Venerito, Marino
AU - Vologzanina, Ludmila
AU - Fadieienko, Galina D.
AU - Fiorini, Giulia
AU - Resina, Elena
AU - Muñoz, Raquel
AU - Cano-Català, Anna
AU - Puig, Ignasi
AU - García-Morales, Natalia
AU - Hernández, Luis
AU - Moreira, Leticia
AU - Megraud, Francis
AU - Morain, Colm O.
AU - Montes, Milagrosa
AU - Gisbert, Javier P.
AU - Fiorinni, Giulia
AU - Saracino, Ilaria Maria
AU - Pabon Carrasco, Manuel
AU - Keco Huerga, Alma
AU - Alfaro Almajano, Enrique
AU - Martinez Dominguez, Samuel Jesus
AU - Alonso Galan, Horacio
AU - Velayos, Benito
AU - Dueñas Sadornil, Carmen
AU - Botargues Bote, Jose Maria
AU - Gonzalez-Cordero, Pedro Luis
AU - Areia, Miguel
AU - Gomez Rodriguez, Blas Jose
AU - Pellicano, Rinaldo
AU - Nuñez, Óscar
AU - Franceschi, Francesco
AU - Alekseenko, Sergey
AU - Perona, Monica
AU - Abdulkhakov, Rustam
AU - Dominguez-Cajal, Manuel
AU - Almela Notari, Pedro
AU - Gomez Camarero, Judith
AU - Jimenez Moreno, Manuel
AU - Algaba, Alicia
AU - Bermejo, Fernando
AU - Tejedor Tejada, Javier
AU - Oblitas Susanibar, Elida
N1 - Publisher Copyright:
© 2024 Wolters Kluwer Health. All rights reserved.
PY - 2024/4/1
Y1 - 2024/4/1
N2 - INTRODUCTION:Antibiotic resistance is one of the main factors that determine the efficacy of treatments to eradicate Helicobacter pylori infection. Our aim was to evaluate the effectiveness of first-line and rescue treatments against H. pylori in Europe according to antibiotics resistance.METHODS:Prospective, multicenter, international registry on the management of H. pylori (European Registry on H. pylori Management). All infected and culture-diagnosed adult patients registered in the Spanish Association of Gastroenterology-Research Electronic Data Capture from 2013 to 2021 were included.RESULTS:A total of 2,852 naive patients with culture results were analyzed. Resistance to clarithromycin, metronidazole, and quinolones was 22%, 27%, and 18%, respectively. The most effective treatment, regardless of resistance, were the 3-in-1 single capsule with bismuth, metronidazole, and tetracycline (91%) and the quadruple with bismuth, offering optimal cure rates even in the presence of bacterial resistance to clarithromycin or metronidazole. The concomitant regimen with tinidazole achieved an eradication rate of 99% (90/91) vs 84% (90/107) with metronidazole. Triple schedules, sequential, or concomitant regimen with metronidazole did not achieve optimal results. A total of 1,118 non-naive patients were analyzed. Resistance to clarithromycin, metronidazole, and quinolones was 49%, 41%, and 24%, respectively. The 3-in-1 single capsule (87%) and the triple therapy with levofloxacin (85%) were the only ones that provided encouraging results.DISCUSSION:In regions where the antibiotic resistance rate of H. pylori is high, eradication treatment with the 3-in-1 single capsule, the quadruple with bismuth, and concomitant with tinidazole are the best options in naive patients. In non-naive patients, the 3-in-1 single capsule and the triple therapy with levofloxacin provided encouraging results.
AB - INTRODUCTION:Antibiotic resistance is one of the main factors that determine the efficacy of treatments to eradicate Helicobacter pylori infection. Our aim was to evaluate the effectiveness of first-line and rescue treatments against H. pylori in Europe according to antibiotics resistance.METHODS:Prospective, multicenter, international registry on the management of H. pylori (European Registry on H. pylori Management). All infected and culture-diagnosed adult patients registered in the Spanish Association of Gastroenterology-Research Electronic Data Capture from 2013 to 2021 were included.RESULTS:A total of 2,852 naive patients with culture results were analyzed. Resistance to clarithromycin, metronidazole, and quinolones was 22%, 27%, and 18%, respectively. The most effective treatment, regardless of resistance, were the 3-in-1 single capsule with bismuth, metronidazole, and tetracycline (91%) and the quadruple with bismuth, offering optimal cure rates even in the presence of bacterial resistance to clarithromycin or metronidazole. The concomitant regimen with tinidazole achieved an eradication rate of 99% (90/91) vs 84% (90/107) with metronidazole. Triple schedules, sequential, or concomitant regimen with metronidazole did not achieve optimal results. A total of 1,118 non-naive patients were analyzed. Resistance to clarithromycin, metronidazole, and quinolones was 49%, 41%, and 24%, respectively. The 3-in-1 single capsule (87%) and the triple therapy with levofloxacin (85%) were the only ones that provided encouraging results.DISCUSSION:In regions where the antibiotic resistance rate of H. pylori is high, eradication treatment with the 3-in-1 single capsule, the quadruple with bismuth, and concomitant with tinidazole are the best options in naive patients. In non-naive patients, the 3-in-1 single capsule and the triple therapy with levofloxacin provided encouraging results.
KW - Helicobacter pylori
KW - non-naive
KW - resistance
KW - treatment
UR - https://journals.lww.com/ajg/fulltext/2024/04000/effectiveness_of_helicobacter_pylori_treatments.17.aspx
UR - https://www.scopus.com/pages/publications/85190097040
U2 - 10.14309/ajg.0000000000002600
DO - 10.14309/ajg.0000000000002600
M3 - Article
C2 - 37983769
SN - 0002-9270
VL - 119
SP - 646
EP - 654
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 4
ER -