Year 2021 / Volume 113 / Number 8
Original
Prospective comparative study of the treatment of Helicobacter pylori with antibiotic susceptibility testing-guided triple therapy compared to quadruple therapy with bismuth-metronidazole-tetracycline subcitrate

597-601

DOI: 10.17235/reed.2020.7395/2020

Rocío Bonoso Criado, Laura Pérez Citores, Antonio Germán Pérez Millán, Ángela Montero Moretón, Elena González de Castro, Luis Cabezudo Molleda, María Antonia García Castro, Bruno Antonio Moreira Da Silva, Sergio Maestro Antolín, Fernando Santos Santamarta, Javier Barcenilla Laguna,

Abstract
Introduction: the current indicated first-line treatment for Helicobacter pylori (H. pylori) infection is the quadruple therapy with bismuth (Pylera®), or the quadruple concomitant therapy without bismuth. The triple therapy was abandoned due to its low eradication rates, partly derived from an increase in antibiotic resistance. The aim of this study was to compare the H. pylori eradication rates guided by antibiotic susceptibility testing (AST) versus Pylera®. Methods: a specimen was taken prospectively for culture and antibiotic susceptibility testing (AST) from all patients diagnosed with H. pylori infection using gastroscopy, and they were randomized to receive triple therapy depending on the results of the AST, or quadruple therapy with Pylera®. The eradication rates of both groups were analyzed using fecal antigen. The adherence and side effects of the treatment were also analyzed. Results: of the 108 patients with H. pylori infection, 55 received Pylera® and 53 AST-guided triple therapy. The eradication rates were 92.7 % with Pylera® and 90.6 % in the AST-guided group, and the difference was statistically significant. There were also no differences found in adherence or side effects. Conclusions: the treatment of H. pylori with AST-guided triple therapy is effective, especially in regions with high rates of antibiotic resistance.
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References
Eusebi LH, Zagari RM, Bazzoli F. Epidemiology of Helicobacter pylori infection. Helicobacter 2014;19(suppl 1):1–5.
F. Sánchez Ceballos, C. Taxonera Samsó, M. García Alonso, et al. Prevalence of Helicobacter pylori infection in the healthy population of Madrid (Spain). Rev. esp. enferm. dig. 2007; 99 (9): 497-501. 1130-0108/2007/99/9/497-501
Correa P, Piazuelo MB, Camargo MC. Etiopathogenesis of gastric cancer. Scand J Surg 2006;95:218-24.
Conteduca V, Sansonno D, Lauletta G, et al. H. pylori infection and gastric cancer: State of the art (review). Int J Oncol 2013;42:5-18.
Sánchez Cuén JA, Irineo Cabrales AB, Bernal Magaña G et al. Regresión de la metaplasia intestinal gástrica tras la erradicación de la infección por Helicobacter pylori en un hospital de México. Rev Esp Enferm Dig 2016;108(12):770-775. DOI: 10.17235/reed.2016.4194/2016.
Gisbert JP, Calvet X, Gomollon F et al. Treatment for the eradication of Helicobacter pylori. Recommendations of the Spanish Consensus Conference. Med Clin (Barc). 2000;114:185-95
Gisbert JP, Calvet X, Gomollon F et al. Eradication treatment of Helicobacter pylori. Recommendations of the II Spanish Consensus Conference. Med Clin (Barc). 2005;125:301-16. DOI: 10.1016/s0025-7753(00)71237-1
Gisbert JP, Calvet X, Bermejo F, et al. III Spanish Consensus Conference on Helicobacter pylori infection. Gastroenterol Hepatol. 2013;36:340-74.
Gisbert JP, Molina-Infante J, Amador J, et al. IV Spanish Consensus Conference on Helicobacter pylori infection. Gastroenterol Hepatol. 2016. http://dx.doi.org/10.1016/j.gastrohep.2016.05.003
Malfertheiner P, Megraud F, O’Morain CA, et al. Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report. Gut. 2017 Jan;66(1):6-30. doi: 10.1136/gutjnl-2016-312288.
Molina-Infante J, Gisbert JP. Update on the efficacy of triple therapy for Helicobacter pylori infection and clarithromycin resistance rates in Spain (2007-2012). Gastroenterol Hepatol. Jun-Jul 2013;36(6):375-81. doi: 10.1016/j.gastrohep.2013.02.006.
Navarro-Jarabo JM, Fernandez-Sanchez F, Fernandez-Moreno N, et al. Prevalence of primary resistance of Helicobacter pylori to clarithromycin and levofloxacin in Southern Spain. Digestion. 2015;92:78-82.
Fallone CA, Chiba N, Veldhuyzen van Zanten S et al. The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults. Gastroenterology 2016;151:51–69.
Cosme A, Lizasoan J, Montes M et al. Antimicrobial Susceptibility-Guided Therapy Versus Empirical Concomitant Therapy for Eradication of Helicobacter pylori in a Region with High Rate of Clarithromycin Resistance. Helicobacter. 2016 Feb;21(1):29-34. doi: 10.1111/hel.12231. Epub 2015 May 15
Costa S, Soares JB et Goncalves R. Efficacy and tolerability of culture-guided treatment for Helicobacter pylori infection. European Journal of Gastroenterology & Hepatology. 2017 Nov;29(11):1258-1263.
Wenzhen Y1, Yumin L, Quanlin G et al. Is antimicrobial susceptibility testing necessary before first-line treatment for Helicobacter pylori infection? Meta-analysis of randomized controlled trials. Intern Med. 2010;49(12):1103-9. Epub 2010 Jun 15
Cammarota G, Ianiro G, Bibbò S et al. Culture-guided treatment approach for Helicobacter pylori infection: Review of the literature. World J Gastroenterol 2014 May 14; 20(18): 5205-521.
Lou Yu, Laisheng Luo, Xiaohua Long et al. Susceptibility-guided therapy for Helicobacter pylori infection treatment failures. Therap Adv Gastroenterol. 2019; 12: 1756284819874922
Chen Q, Long X, Ji Y et al. Randomised controlled trial: susceptibility-guided therapy versus empiric bismuth quadruple therapy for first-line Helicobacter pylori treatment. Aliment Pharmacol Ther. 2019 Jun; 49(11):1385-1394. doi: 10.1111/apt.15273.
Jung W Lee , Nayoung Kim , Ryoung H Nam , et al. Favorable Outcomes of Culture-Based Helicobacter Pylori Eradication Therapy in a Region With High Antimicrobial Resistance. Helicobacter. 2019; 24(2):e12561. doi: 10.1111/hel.12561.
The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters, version 7.1, 2017, http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_7.1_Breakpoint_Tables.pdf
Zullo A. The current role of dual therapy for treatment of Helicobacter pylori: back to the future?. Eur J Gastroenterol Hepatol. 2020;32(5):555-556. doi:10.1097/MEG.0000000000001654
Sho Suzuki , Mitsuru Esaki , Chika Kusano et al. Development of Helicobacter pylori Treatment: How Do We Manage Antimicrobial Resistance? World J Gastroenterol. 2019; 25(16):1907-1912. doi: 10.3748/wjg.v25.i16.1907.
Valle-Muñoz J, Muñoz-Gómez P, Sierra-Bernal C, et al. Tailored Helicobacter pylori eradication based on prior intake of macrolide antibiotics allows the use of triple therapy with optimal results in an area with high clarithromycin resistance. Rev Esp Enferm Dig 2019;11(9):655-61. DOI: 10.17235/reed. 2019.6198/2019
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Bonoso Criado R, Pérez Citores L, Pérez Millán A, Montero Moretón Á, González de Castro E, Cabezudo Molleda L, et all. Prospective comparative study of the treatment of Helicobacter pylori with antibiotic susceptibility testing-guided triple therapy compared to quadruple therapy with bismuth-metronidazole-tetracycline subcitrate. 7395/2020


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Publication history

Received: 08/07/2020

Accepted: 09/09/2020

Online First: 01/12/2020

Published: 28/07/2021

Article revision time: 57 days

Article Online First time: 146 days

Article editing time: 385 days


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