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The Efficacy of Bismuth-based Quadruple and Sequential Therapies in Helicobacter pylori Eradication

Yıl 2020, Cilt: 21 Sayı: 2, 111 - 116, 31.08.2020

Adil Coşkun Mustafa Çelik Altay Kandemir

Öz

Objective: New therapy regimens are needed for Helicobacter pylori (H. pylori) eradication because of increased resistance to the commonly used antibiotics. This study aimed to compare the efficacy of bismuth quadruple therapy versus sequential therapy for H. pylori eradication.
Materials and Methods: Patients who presented with dyspepsia complaints and were diagnosed with H. pylori infection by histopathologic examination of biopsies obtained by gastroscopy were evaluated retrospectively. Two hundred and five patients who received bismuth-based quadruple therapy and sequential therapy for H. pylori eradication were included in the study. Bismuth-based quadruple therapy group were given pantoprazole 2x40 mg, bismuth subcitrate 4x300 mg, amoxicillin 2x1000 mg and metronidazole 3x500 mg for 14 days. In the bismuthbased sequential therapy group, the protocol was as follows; pantoprazole 2x40 mg (14 days), bismuth subcitrate 4x300 mg (14 days), amoxicillin 2x1000 mg (first 7 days), metronidazole 3x500 mg (second 7 days) and levofloxacin 1x500 mg (second 7 days). Eradication was determined by stool H. pylori Antigen test six weeks after the treatment.
Results: A total of 102 patients in group 1 and 91 patients in group 2 completed the treatment and there was no significant difference between the two groups (p=0.310). H. pylori eradication rate showed no significant difference between the two groups (p=0.093), while group 1 attained a better eradication rate than group 2 on intention-to-treat, which was statistically significant (p=0.033).
Conclusion: We achieved better eradication rates with bismuth-based quadruple therapy compared to the sequential therapy. We recommend bismuth-based quadruple regimen as the first-line eradication therapy to avoid drug incompatabilities seen during the sequential regime.

Anahtar Kelimeler

Helicobacter pylori quadruple treatment sequential treatment

Kaynakça

  • 1. Morgan DR, Crowe SE. Helicobacter pylori infection. In: Sleisenger MH, Fordtran JS, (Eds). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 10th ed. Philedelphia: Saunders, 2010; 856-67.
  • 2. Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol 2017; 112: 212-39.
  • 3. Roubaud Baudron C, Franceschi F, Salles N, Gasbarrini A. Extragastric diseases and Helicobacter pylori. Helicobacter 2013; 18: 44-51.
  • 4. Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology 2017; 153: 420-9.
  • 5. Sezikli M, Çetinkaya ZA, Güzelbulut F, Yeşil A, Coşgun S, Kurdaş OÖ. Supplementing vitamins C and E to standard triple therapy for the eradication of Helicobacter pylori. J Clin Pharm Ther 2012; 37: 282-5.
  • 6. Avşar E, Tiftikçi A, Poturoğlu S, Erzin Y, Kocakaya O, Dinçer D, et al. A multicenter, randomized, prospective study of 14-day ranitidine bismuth citrate vs. lansoprazole-based triple therapy fort he eradication of Helicobacter pylori in dyspeptic patients. Turk J Gastroenterol 2013; 24: 316-21.
  • 7. Lee JY, Park KS. Optimal First-Line Treatment for Helicobacter pylori Infection: Recent Strategies. Gastroenterol Res Pract 2016; 2016: 9086581.
  • 8. Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut 2017; 66: 6-30.
  • 9. Polat Z, Kadayifci A, Kantarcioglu M, Ozcan A, Emer O, Uygun A. Comparison of levofloxacin-containing sequential and standard triple therapies for the eradication of Helicobacter pylori. Eur J Intern Med 2012; 23: 165-8.
  • 10. Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev 2006; 19: 449-90.
  • 11. Kadayifci A, Buyukhatipoglu H, Cemil Savas M, Simsek I. Eradication of Helicobacter pylori with triple therapy: an epidemiologic analysis of trends in Turkey over 10 years. Clin Ther 2006; 28: 1960-6.
  • 12. Onder G, Aydin A, Akarca U, Tekin F, Ozutemiz O, Ilter T. High Helicobacter pylori resistance rate to clarithromycin in Turkey. J Clin Gastroenterol 2007; 41: 747-50.
  • 13. Sasaki M, Ogasawara N, Utsumi K, Kawamura N, Kamiya T, Kataoka H, et al. Changes in 12-year first-line eradication rate of Helicobacter pylori based on tripletherapy with proton pump inhibitor, amoxicillin and clarithromycin. J Clin Biochem Nutr 2010; 47: 53-8.
  • 14. Cagdas U, Otag F, Tezcan S, Sezgin O, Aslan G, Emekdas G. \[Detection of Helicobacter pylori and antimicrobial resistance in gastric biopsy specimens]. Mikrobiyol Bul 2012; 46: 398-409.
  • 15. Kalem F, Ozdemir M, Basaranoglu M, Toy H, Baysal B. Helicobacter pylori isolates recovered from antral gastric biopsies of patients with dyspeptic symptoms: Antimicrobial resistance of metronidazole, clarithromycin and amoxicillin. Anatol J Clin Investig 2012; 6: 37-40.
  • 16. Caliskan R, Tokman HB, Erzin Y, Saribas S, Yuksel P, Bolek BK, et al. Antimicrobial resistance of Helicobacter pylori strains to five antibiotics, including levofloxacin, in Northwestern Turkey. Rev Soc Bras Med Trop 2015; 48: 278-84.
  • 17. Ozbey SB, Cuneyt O, Murat K. Antbiotic resistance rates of Helicobacter pylori isolates and the comparison of E-Test and fluorescent in situ hybridization methods for the detection of clarithromycin resistant strains. Mikrobiyol Bul 2009; 43: 227-34.
  • 18. Alkim H, Koksal AR, Boga S, Sen I, Alkim C. Role of Bismuth in the Eradication of Helicobacter pylori. Am J Ther 2017; 24: e751-7.
  • 19. Dore MP, Graham DY, Mele R, Marras L, Nieddu S, Manca A, et al. Colloidal bismuth subcitrate-based twice-a-day quadruple therapy as primary or salvage therapy for Helicobacter pylori infection. Am J Gastroenterol 2002; 97: 857-60.
  • 20. Gokcan H, Oztas E, Onal IK. Different bismuth-based therapies for eradicating Helicobacter pylori: Randomized clinical trial of efficacy and safety. Clin Res Hepatol Gastroenterol 2016; 40: 124-31.
  • 21. Unler GK, Teke Ozgur G, Gokturk HS, Karakoca A, Erinanc OH. A Comparison of Five Different Treatment Regimens as the First-Line Treatment of Helicobacter pylori in Turkey. Helicobacter 2016; 21: 279-85.
  • 22. Kekilli M, Onal IK, Ocal S, Dogan Z, Tanoglu A. Inefficacy of triple therapy and comparison of two different bismuth-containing quadruple regimens as a firstline treatment option for helicobacter pylori. Saudi J Gastroenterol 2016; 22: 366-9.
  • 23. Lee H, Hong SN, Min BH, Lee JH, Rhee PL, Lee YC, et al. Comparison of efficacy and safety of levofloxacin-containing versus standard sequential therapy in eradication of Helicobacter pylori infection in Korea. Dig Liver Dis 2015; 47: 114-8.
  • 24. Romano M, Cuomo A, Gravina AG, Miranda A, Iovene MR, Tiso A, et al. Empirical levofloxacin-containing versus clarithromycin-containing sequential therapy for Helicobacter pylori eradication: a randomised trial. Gut 2010; 59: 1465-70.
  • 25. Aydin A, Oruc N, Turan I, Ozutemiz O, Tuncyurek M, Musoglu A. The modified sequential treatment regimen containing levofloxacin for Helicobacter pylori eradication in Turkey. Helicobacter 2009; 14: 520-4.

Yıl 2020, Cilt: 21 Sayı: 2, 111 - 116, 31.08.2020

Adil Coşkun Mustafa Çelik Altay Kandemir

Öz

Kaynakça

  • 1. Morgan DR, Crowe SE. Helicobacter pylori infection. In: Sleisenger MH, Fordtran JS, (Eds). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 10th ed. Philedelphia: Saunders, 2010; 856-67.
  • 2. Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol 2017; 112: 212-39.
  • 3. Roubaud Baudron C, Franceschi F, Salles N, Gasbarrini A. Extragastric diseases and Helicobacter pylori. Helicobacter 2013; 18: 44-51.
  • 4. Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology 2017; 153: 420-9.
  • 5. Sezikli M, Çetinkaya ZA, Güzelbulut F, Yeşil A, Coşgun S, Kurdaş OÖ. Supplementing vitamins C and E to standard triple therapy for the eradication of Helicobacter pylori. J Clin Pharm Ther 2012; 37: 282-5.
  • 6. Avşar E, Tiftikçi A, Poturoğlu S, Erzin Y, Kocakaya O, Dinçer D, et al. A multicenter, randomized, prospective study of 14-day ranitidine bismuth citrate vs. lansoprazole-based triple therapy fort he eradication of Helicobacter pylori in dyspeptic patients. Turk J Gastroenterol 2013; 24: 316-21.
  • 7. Lee JY, Park KS. Optimal First-Line Treatment for Helicobacter pylori Infection: Recent Strategies. Gastroenterol Res Pract 2016; 2016: 9086581.
  • 8. Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut 2017; 66: 6-30.
  • 9. Polat Z, Kadayifci A, Kantarcioglu M, Ozcan A, Emer O, Uygun A. Comparison of levofloxacin-containing sequential and standard triple therapies for the eradication of Helicobacter pylori. Eur J Intern Med 2012; 23: 165-8.
  • 10. Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev 2006; 19: 449-90.
  • 11. Kadayifci A, Buyukhatipoglu H, Cemil Savas M, Simsek I. Eradication of Helicobacter pylori with triple therapy: an epidemiologic analysis of trends in Turkey over 10 years. Clin Ther 2006; 28: 1960-6.
  • 12. Onder G, Aydin A, Akarca U, Tekin F, Ozutemiz O, Ilter T. High Helicobacter pylori resistance rate to clarithromycin in Turkey. J Clin Gastroenterol 2007; 41: 747-50.
  • 13. Sasaki M, Ogasawara N, Utsumi K, Kawamura N, Kamiya T, Kataoka H, et al. Changes in 12-year first-line eradication rate of Helicobacter pylori based on tripletherapy with proton pump inhibitor, amoxicillin and clarithromycin. J Clin Biochem Nutr 2010; 47: 53-8.
  • 14. Cagdas U, Otag F, Tezcan S, Sezgin O, Aslan G, Emekdas G. \[Detection of Helicobacter pylori and antimicrobial resistance in gastric biopsy specimens]. Mikrobiyol Bul 2012; 46: 398-409.
  • 15. Kalem F, Ozdemir M, Basaranoglu M, Toy H, Baysal B. Helicobacter pylori isolates recovered from antral gastric biopsies of patients with dyspeptic symptoms: Antimicrobial resistance of metronidazole, clarithromycin and amoxicillin. Anatol J Clin Investig 2012; 6: 37-40.
  • 16. Caliskan R, Tokman HB, Erzin Y, Saribas S, Yuksel P, Bolek BK, et al. Antimicrobial resistance of Helicobacter pylori strains to five antibiotics, including levofloxacin, in Northwestern Turkey. Rev Soc Bras Med Trop 2015; 48: 278-84.
  • 17. Ozbey SB, Cuneyt O, Murat K. Antbiotic resistance rates of Helicobacter pylori isolates and the comparison of E-Test and fluorescent in situ hybridization methods for the detection of clarithromycin resistant strains. Mikrobiyol Bul 2009; 43: 227-34.
  • 18. Alkim H, Koksal AR, Boga S, Sen I, Alkim C. Role of Bismuth in the Eradication of Helicobacter pylori. Am J Ther 2017; 24: e751-7.
  • 19. Dore MP, Graham DY, Mele R, Marras L, Nieddu S, Manca A, et al. Colloidal bismuth subcitrate-based twice-a-day quadruple therapy as primary or salvage therapy for Helicobacter pylori infection. Am J Gastroenterol 2002; 97: 857-60.
  • 20. Gokcan H, Oztas E, Onal IK. Different bismuth-based therapies for eradicating Helicobacter pylori: Randomized clinical trial of efficacy and safety. Clin Res Hepatol Gastroenterol 2016; 40: 124-31.
  • 21. Unler GK, Teke Ozgur G, Gokturk HS, Karakoca A, Erinanc OH. A Comparison of Five Different Treatment Regimens as the First-Line Treatment of Helicobacter pylori in Turkey. Helicobacter 2016; 21: 279-85.
  • 22. Kekilli M, Onal IK, Ocal S, Dogan Z, Tanoglu A. Inefficacy of triple therapy and comparison of two different bismuth-containing quadruple regimens as a firstline treatment option for helicobacter pylori. Saudi J Gastroenterol 2016; 22: 366-9.
  • 23. Lee H, Hong SN, Min BH, Lee JH, Rhee PL, Lee YC, et al. Comparison of efficacy and safety of levofloxacin-containing versus standard sequential therapy in eradication of Helicobacter pylori infection in Korea. Dig Liver Dis 2015; 47: 114-8.
  • 24. Romano M, Cuomo A, Gravina AG, Miranda A, Iovene MR, Tiso A, et al. Empirical levofloxacin-containing versus clarithromycin-containing sequential therapy for Helicobacter pylori eradication: a randomised trial. Gut 2010; 59: 1465-70.
  • 25. Aydin A, Oruc N, Turan I, Ozutemiz O, Tuncyurek M, Musoglu A. The modified sequential treatment regimen containing levofloxacin for Helicobacter pylori eradication in Turkey. Helicobacter 2009; 14: 520-4.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Gastroenteroloji ve Hepatoloji
Bölüm Araştırma Makalesi
Yazarlar

Adil Coşkun

Mustafa Çelik

Altay Kandemir

Yayımlanma Tarihi 31 Ağustos 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 21 Sayı: 2

Kaynak Göster

EndNote Coşkun A, Çelik M, Kandemir A (01 Ağustos 2020) The Efficacy of Bismuth-based Quadruple and Sequential Therapies in Helicobacter pylori Eradication. Meandros Medical And Dental Journal 21 2 111–116.