Update on the first-line treatment for Helicobacter pylori infection - a continuing challenge from an old enemy
Abstract Because the prevalence of antibiotic resistance markedly increases with time worldwide, anti-H. pylori treatment is continuing to be a great challenge forsphysicians in clinical practice. The Real-world Practice & Expectation of Asia-Pacific Physicians and Patients in Helicobacter Pylor...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | Biomarker Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40364-017-0103-x |
| _version_ | 1819057065415409664 |
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| author | Chih-Chieh Huang Kuo-Wang Tsai Tzung-Jiun Tsai Ping-I Hsu |
| author_facet | Chih-Chieh Huang Kuo-Wang Tsai Tzung-Jiun Tsai Ping-I Hsu |
| author_sort | Chih-Chieh Huang |
| collection | DOAJ |
| description | Abstract Because the prevalence of antibiotic resistance markedly increases with time worldwide, anti-H. pylori treatment is continuing to be a great challenge forsphysicians in clinical practice. The Real-world Practice & Expectation of Asia-Pacific Physicians and Patients in Helicobacter Pylori Eradication (REAP-HP) Survey demonstrated that the accepted minimal eradication rate of anti-H. pylori regimen in H. pylori-infected patients was 91%. The Kyoto Consensus Report on Helicobacter Pylori Gastritis also recommended that, within any region, only regimens which reliably produce eradication rates of ≥90% in that population should be used for empirical treatment. This article is aimed to review current first-line eradication regimens with a per-protocol eradication rate exceeding 90% in most geographic areas. In regions with low (≦15%) clarithromycin resistance, 14-day hybrid (or reverse hybrid), 10 ~ 14-day sequential, 7 ~ 14-day concomitant, 10 ~ 14-day bismuth quadruple or 14-day triple therapy can achieve a high eradication rate in the first-line treatment of H. pylori infection. However, in areas with high (>15%) clarithromycin resistance, standard triple therapy should be abandoned because of low eradication efficacy, and 14-day hybrid (or reverse hybrid), 10 ~ 14-day concomitant or 10 ~ 14-day bismuth quadruple therapy are the recommended regimens. If no recent data of local antibiotic resistances of H. pylori strains are available, universal high efficacy regimens such as 14-day hybrid (or reverse hybrid), concomitant or bismuth quadruple therapy can be adopted to meet the recommendation of consensus report and patients’ expectation. |
| first_indexed | 2024-12-21T13:33:23Z |
| format | Article |
| id | doaj.art-7932cf22961341a896fb708bc16a05e9 |
| institution | Directory Open Access Journal |
| issn | 2050-7771 |
| language | English |
| last_indexed | 2024-12-21T13:33:23Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Biomarker Research |
| spelling | doaj.art-7932cf22961341a896fb708bc16a05e92022-12-21T19:02:14ZengBMCBiomarker Research2050-77712017-07-01511610.1186/s40364-017-0103-xUpdate on the first-line treatment for Helicobacter pylori infection - a continuing challenge from an old enemyChih-Chieh Huang0Kuo-Wang Tsai1Tzung-Jiun Tsai2Ping-I Hsu3Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital and National Yang-Ming UniversityDepartment of Medical Education and Research, Kaohsiung Veterans General HospitalDivision of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital and National Yang-Ming UniversityDivision of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital and National Yang-Ming UniversityAbstract Because the prevalence of antibiotic resistance markedly increases with time worldwide, anti-H. pylori treatment is continuing to be a great challenge forsphysicians in clinical practice. The Real-world Practice & Expectation of Asia-Pacific Physicians and Patients in Helicobacter Pylori Eradication (REAP-HP) Survey demonstrated that the accepted minimal eradication rate of anti-H. pylori regimen in H. pylori-infected patients was 91%. The Kyoto Consensus Report on Helicobacter Pylori Gastritis also recommended that, within any region, only regimens which reliably produce eradication rates of ≥90% in that population should be used for empirical treatment. This article is aimed to review current first-line eradication regimens with a per-protocol eradication rate exceeding 90% in most geographic areas. In regions with low (≦15%) clarithromycin resistance, 14-day hybrid (or reverse hybrid), 10 ~ 14-day sequential, 7 ~ 14-day concomitant, 10 ~ 14-day bismuth quadruple or 14-day triple therapy can achieve a high eradication rate in the first-line treatment of H. pylori infection. However, in areas with high (>15%) clarithromycin resistance, standard triple therapy should be abandoned because of low eradication efficacy, and 14-day hybrid (or reverse hybrid), 10 ~ 14-day concomitant or 10 ~ 14-day bismuth quadruple therapy are the recommended regimens. If no recent data of local antibiotic resistances of H. pylori strains are available, universal high efficacy regimens such as 14-day hybrid (or reverse hybrid), concomitant or bismuth quadruple therapy can be adopted to meet the recommendation of consensus report and patients’ expectation.http://link.springer.com/article/10.1186/s40364-017-0103-xHelicobacter pyloriFirst-lineTherapyHybrid therapySequential therapyConcomitant therapy |
| spellingShingle | Chih-Chieh Huang Kuo-Wang Tsai Tzung-Jiun Tsai Ping-I Hsu Update on the first-line treatment for Helicobacter pylori infection - a continuing challenge from an old enemy Biomarker Research Helicobacter pylori First-line Therapy Hybrid therapy Sequential therapy Concomitant therapy |
| title | Update on the first-line treatment for Helicobacter pylori infection - a continuing challenge from an old enemy |
| title_full | Update on the first-line treatment for Helicobacter pylori infection - a continuing challenge from an old enemy |
| title_fullStr | Update on the first-line treatment for Helicobacter pylori infection - a continuing challenge from an old enemy |
| title_full_unstemmed | Update on the first-line treatment for Helicobacter pylori infection - a continuing challenge from an old enemy |
| title_short | Update on the first-line treatment for Helicobacter pylori infection - a continuing challenge from an old enemy |
| title_sort | update on the first line treatment for helicobacter pylori infection a continuing challenge from an old enemy |
| topic | Helicobacter pylori First-line Therapy Hybrid therapy Sequential therapy Concomitant therapy |
| url | http://link.springer.com/article/10.1186/s40364-017-0103-x |
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