Effectiveness of Helicobacter pylori Treatments According to Antibiotic Resistance-Reference-Cited by-同舟云学术

Effectiveness of Helicobacter pylori Treatments According to Antibiotic Resistance

Published:2024-01-22 Issue: Volume: Page:
ISSN:0002-9270
Container-title:American Journal of Gastroenterology
language:en
Short-container-title:Am J Gastroenterol

Author:

Bujanda Luis¹^ORCID,Nyssen Olga P.²^ORCID,Ramos June¹^ORCID,Bordin Dmitry S.³^ORCID,Tepes Bojan⁴^ORCID,Perez-Aisa Angeles⁵,Pavoni Matteo⁶,Castro-Fernandez Manuel⁷,Lerang Frode⁸^ORCID,Leja Mārcis⁹,Rodrigo Luis¹⁰,Rokkas Theodore¹¹^ORCID,Kupcinskas Juozas¹²,Jonaitis Laimas¹²,Shvets Oleg¹³,Gasbarrini Antonio¹⁴,Simsek Halis¹⁵,Phull Perminder S.¹⁶^ORCID,Buzás György Miklós¹⁷^ORCID,Machado Jose C.¹⁸,Boltin Doron¹⁹^ORCID,Boyanova Lyudmila²⁰,Tonkić Ante²¹,Marlicz Wojciech²²^ORCID,Venerito Marino²³^ORCID,Vologzanina Ludmila²⁴,Fadieienko Galina D.²⁵,Fiorini Giulia⁶,Resina Elena²^ORCID,Muñoz Raquel²^ORCID,Cano-Català Anna²⁶,Puig Ignasi²⁷^ORCID,García-Morales Natalia²⁸^ORCID,Hernández Luis²⁹^ORCID,Moreira Leticia³⁰^ORCID,Megraud Francis³¹,Morain Colm O.³²^ORCID,Montes Milagrosa³³^ORCID,Gisbert Javier P.²

Affiliation:

1. Department of Gastroenterology, Biodonostia Health Research Institute, San Sebastián; CIBERehd, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid; Department of Medicine, Universidad Del País Vasco (UPV/EHU), San Sebastián, Spain;

2. Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain;

3. Department of Pancreatic, Biliary and Upper Digestive Tract Disorders, A. S. Loginov Moscow Clinical Scientific Center, Moscow; Department of Propaedeutic of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow; Department of Outpatient Therapy and Family Medicine, Tver State Medical University, Tver, Russia;

4. Department of Gastroenterology, DC Rogaska, Slatina, Slovenia;

5. Digestive Unit, Agencia Sanitaria Costa Del Sol, Marbella, Spain;

6. Department of Medical and Surgical Sciences, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy;

7. Aparato Digestivo, Hospital Universitario de Valme, Sevilla, Spain;

8. Department of Gastroenterology, Østfold Hospital Trust, Grålum, Norway;

9. Gastro, Digestive Diseases Centre, Riga; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia;

10. Gastroenterology, University of Oviedo, Oviedo, Spain;

11. Gastroenterology Clinic, Henry Dunant Hospital, Athens, Greece;

12. Institute for Digestive Research and Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania;

13. Department of Gastroenterology, Internal Medicine, National Medical University, Kyiv, Ukraine;

14. Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy;

15. Department of Gastroenterology, Hacettepe University, Ankara; Department of Gastroenterology, HC International Clinic, Ankara, Turkey;

16. Department of Digestive Disorders, Aberdeen Royal Infirmary, Aberdeen, UK;

17. Gastroenterology, Ferencváros Health Center, Budapest, Hungary;

18. 3S–Instituto de Investigação e Inovação Em Saúde da Universidade Do Porto, Porto; Ipatimup–Instituto de Patologia e Imunologia Molecular da Universidade Do Porto, Porto; Pathology, FMUP–Faculdade de Medicina Do Porto, Porto, Portugal;

19. Division of Gastroenterology, Rabin Medical Center, PetahTikva; Sackler School of Medicine, Tel Aviv University, TelAviv, Israel;

20. Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria;

21. Department of Gastroenterology, University Hospital of Split, Split, Croatia;

22. Department of Gastroenterology, Pomeranian Medical University in Szczecin, Szczecin; The Centre for Digestive Diseases, Endoklinika, Szczecin, Poland;

23. Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital of Magdeburg, Magdeburg, Germany;

24. Gastrocenter, Perm, Russia;

25. L.T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine;

26. GOES Research Group, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain;

27. Althaia Xarxa Assistencial Universitària de Manresa and Universitat de Vic-Universitat Central de Catalunya (UVicUCC), Manresa, Spain;

28. Complexo Hospitalario Universitario de Vigo (CHUVI) and Galicia Sur Health Research Institute (IIS Galicia Sur); SERGAS-UVIGO, Spain;

29. Unidad de Gastroenterología, Hospital Santos Reyes, Aranda de Duero, Spain;

30. Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), IDIBAPS (Institut D'Investigacions Biomèdiques August Pi I Sunyer), University of Barcelona, Barcelona, Spain;

31. INSERM U1312, Université de Bordeaux, Bordeaux, France;

32. Trinity College Dublin, Dublin, Ireland;

33. Department of Microbiology, Donostia University Hospital-Biodonostia Health Research Institute, San Sebastian, Spain .

Abstract

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.

Funder

HORIZON EUROPE Reforming and enhancing the European Research and Innovation system

United Kingdom Clinical Research Collaboration

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Gastroenterology,Hepatology

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