Literature DB >> 26831613

Updated Helicobacter pylori management in 2015.

Amin Talebi Bezmin Abadi1.   

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Year:  2016        PMID: 26831613      PMCID: PMC4763535          DOI: 10.4103/1319-3767.173765

Source DB:  PubMed          Journal:  Saudi J Gastroenterol        ISSN: 1319-3767            Impact factor:   2.485


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Sir, We read the editorial by Pellicano et al. on the evaluation of one or two weeks of treatment of Helicobacter pylori infection with standard triple therapy in the previous issue of Saudi Journal of Gastroenterology.[1] Despite the fact that various regimens, including sequential and quadruple therapy are recommended, these current therapeutic regimens lack efficacy in eradication due to antibiotic resistance, poor patient compliance, and associated adverse events. With respect to the current article, some constructive points are worth considering. First, the proton pump inhibitor (PPI)-containing triple regimen is surely one of the most widely prescribed therapies for firstline treatment of H. pylori infection.[2] Currently, PPI-containing triple therapy for 7 days is most often used worldwide. It has been frequently shown that seven-day H. pylori eradication therapy is preferable than a 14-day therapy. Unfortunately, there is no general agreement on which duration can provide better efficacy with lesser side effects. We are well aware that seven days PPI-containing triple therapy is better than a 14-day therapy in view of the low cost, better compliance, and lesser side effects. In essence, newer antimicrobial regimens containing more efficacious agents are necessary to design better eradication rates against this bacterium. Second, recent therapeutic approaches, including novel nanoparticles with anti-H. pylori properties, Lactobacilli as probiotic supplementation, and flouroquinolone application in firstline therapy are the remaining options to apply against this persistent and resistant gastric infection. Thus, despite the current bleak situation of H. pylori management, evolving smart strategies in clinical practice could potentially overcome this problem. Third, until optimal firstline H. pylori eradication therapies are discovered, various therapeutic regimens with shorter durations should be used with caution, due to limitations that affect the options. In contrast to the authors’ opinion, we believe that the optimal duration of therapy against H. pylori is not validated yet. Studies with larger number of patients are needed to confirm if there is any benefit in increasing the duration.[34] In the era that we have dealt with H. pylori eradication, it may be inferred that we are at early days to draw meaningful conclusions for actual optimal duration of H. pylori treatment. Finally, if bacterial culture is not available (for reasons of not being routinely performed in diagnostic laboratories, being a time-consuming procedure or the associated costs), molecular detection can help clinicians to predict antimicrobial resistance and following drug therapy can be a remarkably better option. To our knowledge, flouroquinolone-based therapy, followed by specific polymerase chain reaction performance to detect its mutations, is a good alternative in clinical practice. In conclusion, regardless of how it ought to be treated with existing strategies, H. pylori eradication remains an ultimate target for gastroenterologists in 2015 and later.

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  4 in total

Review 1.  Optimal therapy for Helicobacter pylori infections.

Authors:  Emiko Rimbara; Lori A Fischbach; David Y Graham
Journal:  Nat Rev Gastroenterol Hepatol       Date:  2011-02       Impact factor: 46.802

2.  Primary resistance of Helicobacter pylori to levofloxacin and moxifloxacine in Iran.

Authors:  Amin Talebi Bezmin Abadi; Ali Ghasemzadeh; Tarang Taghvaei; Ashraf Mohabbati Mobarez
Journal:  Intern Emerg Med       Date:  2011-03-25       Impact factor: 3.397

Review 3.  Choosing optimal first-line Helicobacter pylori therapy: a view from a region with high rates of antibiotic resistance.

Authors:  Alexander A Nijevitch; Bulat Idrisov; Elsa N Akhmadeeva; David Y Graham
Journal:  Curr Pharm Des       Date:  2014       Impact factor: 3.116

4.  One or two weeks of treatment with Helicobacter Pylori ''standard'' triple therapy in the year 2015?

Authors:  Rinaldo Pellicano; Sharmila Fagoonee
Journal:  Saudi J Gastroenterol       Date:  2015 Nov-Dec       Impact factor: 2.485

  4 in total
  2 in total

1.  Response to: Reply on "Renewed Helicobacter pylori management and therapy in 2015".

Authors:  Sharmila Fagoonee; Rinaldo Pellicano
Journal:  Saudi J Gastroenterol       Date:  2016 Jan-Feb       Impact factor: 2.485

2.  Management of Helicobacter pylori infections.

Authors:  Amin Talebi Bezmin Abadi; Johannes G Kusters
Journal:  BMC Gastroenterol       Date:  2016-08-12       Impact factor: 3.067

  2 in total

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