Kefeli A, Basyigit S, Yeniova AO, Kefeli TT, Aslan M, Tanas O. . Können Helicobacter-pylori-Bakterien auch ohne Antibiotika behandelt werden. However, the efficacy of this regimen may be lower than observed in the systematic review as indicated in the Korean retrospective study. As a library, NLM provides access to scientific literature. Effect of IL-1 polymorphisms, CYP2C19 genotype and antibiotic resistance on Helicobacter pylori eradication comparing between 10-day sequential therapy and 14-day standard triple therapy with four-times-daily-dosing of amoxicillin in Thailand: a prospective randomized study. Minakari M, Davarpanah Jazi AH, Shavakhi A, Moghareabed N, Fatahi F. A randomized controlled trial: efficacy and safety of azithromycin, ofloxacin, bismuth, and omeprazole compared with amoxicillin, clarithromycin, bismuth, and omeprazole as second-line therapy in patients with Helicobacter pylori infection. The prevalence of H. pylori in Korea is estimated to be 54% (95% CI, 50.1% to 57.8%) according to a study that estimates the prevalence of H. pylori worldwide.59 In areas with high prevalence of H. pylori, costs, adverse effects associated with eradication therapy, the risk of emergence of resistance strains, and re-infection are thought to be higher than those of low prevalence regions. 7). H. pylori 10. They had highly heterogeneous designs among the studies with eradication rates ranging 77.8% to 96.3%. *Risk of bias: A, random sequence generation (selection bias); B, allocation concealment (selection bias); C, blinding of participants and personnel (performance bias); D, blinding of outcome assessment (detection bias); E, incomplete outcome data (attrition bias); F, selective reporting (reporting bias); G, other bias. An official website of the United States government. In the 2013 revised Korean guidelines, bismuth quadruple therapy (PPI, bismuth, tetracycline, and metronidazole) for 7–14 days was recommended. Helicobacter A literature search was conducted to utilize resources and economic evaluation. Helicobacter pylori eradication in functional dyspepsia: HEROES trial. The efficacy of second-line anti-Helicobacter pylori therapy using an extended 14-day levofloxacin/amoxicillin/proton-pump inhibitor treatment: a pilot study. Comparison of the occurrence of metachronous gastric cancer after endoscopic resection of gastric adenoma between Helicobacter pylori (Hp) eradication and placebo treatment. Antibiotic resistance in Helicobacter pylori strains and its effect on H. pylori eradication rates in a single center in Korea. In these cases, it is not recommended to use clarithromycin again in the third-line regimen.184 It would be also inappropriate to use clarithromycin after failure of first-line bismuth quadruple therapy because this regimen had been chosen as first-line when clarithromycin resistance was suspected.8 Treatment regimen may be decided based on antibiotics susceptibility tests, either by culture, PCR, or sequencing analysis. The eradication rates from 2012 to 2016 were 70.3% (95% CI, 68.4% to 72.1%) in ITT analysis and 77.4% (95% CI, 75.6% to 79.2%) in PP analysis. (A) 10-day/14-day PBMT versus 14-day TT; (B) 10-day/14-day PBMT versus 10-day SQT; and (C) 10-day/14-day PBMT versus 10-day CCT. Dazu sollen genetisch modifizierte und dadurch harmlose Helicobacter-Bakterien als Wirkstofftransportsystem erzeugt werden. After failure of standard triple therapy, a bismuths quadruple therapy (PPI, bismuth, tetracycline, and metronidazole) for 14 days is recommended as a second-line therapy. In the large case-control study (n=1,232), the patients who had the A2142G and A2143G point mutations associated with clarithromycin resistance based on dual priming oligonucleotide-based multiplex PCR were treated with PPI + amoxicillin + metronidazole (PAM) for 7 days, and the patients without clarithromycin resistance were treated with standard triple therapy for 7 days (tailored therapy). Rifabutin-based 10-day and 14-day triple therapy as a third-line and fourth-line regimen for Helicobacter pylori eradication: a pilot study. Malfertheiner P, MOssner J, Fischbach W, et al. Antibiotika: Bei einer chronischen Gastritis vom Typ B gilt es, die krankmachenden Bakterien loszuwerden. Das säurehemmende Medikament sorgt dafür, dass die Wirksamkeit der Antibiotika gewährleistet ist und das Abheilen der Entzündung schnell verläuft. The eradication rates of sequential therapy and overall standard triple therapy were 84.1% and 74.9% in the ITT analysis, respectively. Li WQ, Ma JL, Zhang L, et al. Gu LY, Lin WW, Lu H, Chen XY, Ge ZZ, Li XB. Shin WG, Lee SW, Baik GH, et al. The literature selection process was summarized in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) plot for each PICO. Peptic ulcer disease. The first round was investigated using the 9-Likert scale self-reporting questionnaire asking the extent of agreement, along with evidence data from the Development Committee for each recommendation. Efficacy and safety of sequential therapy versus standard triple therapy in Helicobacter pylori eradication in Kashmir India: a randomized comparative trial. in Kombination mit mehreren (meistens zwei) Antibiotika. Eine Kombination von zwei beziehungsweise drei Antibiotika zusammen mit einem Protonenpumpenhemmer über sieben Tage vertreibt beispielsweise Helicobacter pylori in über 90 Prozent der Fälle. Second-line Helicobacter pylori eradication: a randomized comparison of 1-week or 2-week bismuth-containing quadruple therapy. This guideline has been published jointly with consent in both the Gut and Liver and The Korean Journal of Efficacy of Helicobacter pylori eradication therapy on functional dyspepsia: a meta-analysis of randomized controlled studies with 12-month follow-up. Antibiotika. 6). In 2013, the Japanese health insurance has begun covering eradication therapy for H. pylori-positive gastritis, even though there is no concrete evidence on the eradication therapy for H. pylori gastritis.6,7 However, it is not clear whether there is a definite benefit compared to the harms due to their high cost and potential increase in antibiotic resistance with mass eradication therapy to H. pylori infection. We also thank Nayoung Kim, a professor from the Department of Internal Medicine, Seoul National University College of Medicine and Kwang Ha Kim, a professor from the Department of Internal Medicine, Pusan University College of Medicine who reviewed the draft of the guidelines by peer review. This guideline was provided on the Korean College of Helicobacter and Upper Gastrointestinal Research (http://www.hpylori.or.kr) and the Korean Association of Internal Medicine (http://www.kaim.or.kr) websites. Through the systematic search, 21 RCTs comparing 10-day CT with other regimens were selected. Helicobacter-Bakterien - genauer „Helicobacter pylori" - sind Keime, die sich an der Magenschleimhaut und im Darm ansiedeln und dort verschiedene Erkrankungen verursachen können. Boal Carvalho P, Magalhães J, Dias de Castro F, Rosa B, Cotter J. Randomized controlled trial for Helicobacter pylori eradication in a naïve Portuguese population: is sequential treatment superior to triple therapy in real world clinical setting? Welche Behandlung geeignet ist, richtet sich nach der Ursache. Hybrid vs sequential therapy for eradication of Helicobacter pylori in Taiwan: a prospective randomized trial. Absence of benefit of eradicating Helicobacter pylori in patients with nonulcer dyspepsia. In seltenen Fällen sind die Erreger des Magengeschwürs allerdings resistent gegen eines der Antibiotika. Randomized comparison of two non-bismuth-containing second-line rescue therapies for Helicobacter pylori. Finally, we thank the Internet community “Bokanyi” for helping us with the patient preference survey. The eradication rate of 10-day CT was not significantly different from that of bismuth quadruple therapy (RR, 1.05; 95% CI, 0.96 to 1.15 in ITT analysis; RR, 1.01; 95% CI, 0.97 to 1.06 in PP analysis) (Supplementary Fig. Choi JM, Kim SG, Choi J, et al. Comparison between 10-day sequential therapy and standard triple therapy (TT) according to the treatment duration of TT in intention-to-treat analysis. An economic modeling study of Helicobacter pylori eradication: comparison of dual priming oligonucleotide-based multiplex polymerase chain reaction and empirical treatment. Levofloxacin triple therapy showed pooled eradication rate of 73.1% (95% CI, 68.4% to 77.3%) in the meta-analysis of the eight studies (Fig. Blum AL, Talley NJ, O'Moráin C, et al. After failure of non-bismuth quadruple therapy (sequential or concomitant therapy), a bismuth quadruple therapy is recommended as a second-line therapy. Because resistance to metronidazole can be overcome with increased duration and dose, 14-day course would be preferred to 10- to 14-day course for bismuth quadruple therapy as a salvage regimen in Korea.184 Therefore, bismuth quadruple therapy for 14 days is recommended as a second-line therapy after failure of standard triple therapy. GRADE guidelines: 14. Recommendations for the Treatment of Helicobacter pylori. Jung HS, Shim KN, Baik SJ, et al. However, there was no definite guideline about H. pylori eradication after ER of gastric adenoma. Songür Y, Senol A, Balkarli A, Baştürk A, Cerçi S. Triple or quadruple tetracycline-based therapies versus standard triple treatment for Helicobacter pylori treatment. *Risk of bias: A, random sequence generation (selection bias); B, allocation concealment (selection bias); C, blinding of participants and personnel (performance bias); D, blinding of outcome assessment (detection bias); E, incomplete outcome data (attrition bias); F, selective reporting (reporting bias); G, other bias. Lee BH, Kim N, Hwang TJ, et al. 6. One of them was a study conducted in Korea where 14-day bismuth quadruple therapy achieved successful eradication in 10 of 14 patients. When the meta-analysis was performed using the RCTs in the general population only, H. pylori eradication significantly reduced the incidence of gastric cancer, as in previous studies (Fig. Probiotika sind besonders empfehlenswert, da sie durch das Antibiotikum verlorene Bakterien ersetzen und die Lebensbedingungen für den Helicobacter pylori erschweren können. Cho JH, Jeon SR, Kim HG, Jin SY, Park S. Cost-effectiveness of a tailored Helicobacter pylori eradication strategy based on the presence of a 23S ribosomal RNA point mutation that causes clarithromycin resistance in Korean patients. The pooled eradication rate of levofloxacin triple therapy as a second-line therapy was 73.1% (95% confidence interval [CI], 68.4% to 77.3%). Zhou L, Zhang J, Song Z, et al. 4). Molina-Infante J, Lucendo AJ, Angueira T, et al. Does clarithromycin resistance test improve the eradication rate of standard triple therapy? Lee JH, Jung HY, Choi KD, Song HJ, Lee GH, Kim JH. However, it is controversial whether the eradication can be beneficial in individuals with pre-neoplastic lesions including chronic atrophic gastritis (CAG) and IM. Helicobacter pylori eradication versus prokinetics in the treatment of functional dyspepsia: a randomized, double-blind study. Efficacy of levofloxacin and rifaximin based quadruple therapy in Helicobacter pylori associated gastroduodenal disease: a double-blind, randomized controlled trial. The relation between gastric vitamin C concentrations, mucosal histology, and CagA seropositivity in the human stomach. It is the most common cause of gastric and duodenal ulcers and gastric cancer. Hye-Kyung Jung and Seung Joo Kang contributed equally to this work as first authors. To establish the methodology for developing guidelines, two methodological experts (Miyoung Choi and Ein Soon Shin) and Professor Soo Young Kim, a member of the Korean Medical Association’s Clinical Treatment Guidelines Development Committee, conducted four workshops on the literature search, quality assessment, meta-analysis, and methods of expert consensus. Second-line levofloxacin-based triple schemes for Helicobacter pylori eradication. The estimated eradication rate with third-line levofloxacin triple therapy was 56.9% (62/109).189 Although previously failed first- and second-line regimens were not specified in this study, this low eradication rate may have been due to the high levofloxacin resistance rate in Korea.2,14,182,183 Therefore, a levofloxacin triple therapy is suggested as a salvage therapy after failure of first-line or second-line bismuth quadruple therapy. Wird die Entzündung durch Helicobacter pylori ausgelöst, erfolgt häufig eine spezielle Therapie. RCT, randomized controlled trial; SR, systematic review. 7A), 10 days sequential therapy (RR, 0.96; 95% CI, 0.83 to 1.12) (Fig. Studies were divided into 2007–2011 and 2012–2016. Forest plot of studies reporting the impact of Helicobacter pylori eradication on gastric cancer from studies involving the general population. Mori H, Suzuki H, Matsuzaki J, et al. Hintergrund Die Leitlinie zur Helicobacter-pylori-Eradikation wurde im Jahr 2022 überarbeitet. Gisbert JP, Calvet X. Dennoch kann Helicobacter pylori die Entstehung von Folgeerkrankungen begünstigen. Efficacy of rifabutin-based triple therapy as second-line treatment to eradicate Helicobacter pylori infection. In 2013, clinical practice guidelines for diagnosis and treatment of H. pylori infection were developed to address domestic situations with an adaptation process.8. H. pylori eradication can reduce the risk of gastric cancer development. Da diese durch Blut im Stuhl verursacht wird und damit bereits ein Anzeichen eines Magengeschwürs. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. However, because of analysis of RCTs from Asia, the effect of eradication on improvement of dyspeptic symptoms was not significant (RR, 1.10; 95% CI, 0.92 to 1.31; I2=32%). Lansoprazole-based sequential and concomitant therapy for the first-line Helicobacter pylori eradication. Eradication of Helicobacter pylori prevents cancer development in subjects with mild gastric atrophy identified by serum pepsinogen levels. Kim BJ, Lee H, Lee YC, et al. Infection with the Gram-negative pathogen Helicobacter pylori (H. pylori) has been associated with gastro-duodenal disease and the importance of H. pylori eradication is underscored by its designation as a group I carcinogen. Im Labor kombinierten die Wissenschafter:innen die Linolensäure mit moderner Nanotechnologie, um sie auch medizinisch einsetzen zu können. In these updated guidelines, we aimed to present the appropriate H. pylori treatment for Korea by conducting systematic review and meta-analysis to identify the clinical evidence for alternative treatments to the standard 7-day triple therapy. Randomised clinical trial: a comparative study of 10-day sequential therapy with 7-day standard triple therapy for Helicobacter pylori infection in naïve patients. Kang SJ, Park B, Shin CM. Meta-analyses were conducted and there were more than three RCTs. The quality of finally selected studies was assessed using quality assessment tools according to the study design. The eradication rate of 14-day CT did not differ from that of 10-day/14-day sequential therapy in the ITT analysis (76% vs 79%), but in the PP analysis, the eradication rate of 14-day CT was slightly higher than that of sequential therapy (89% vs 82%). Veldhuyzen van Zanten S, Fedorak RN, Lambert J, Cohen L, Vanjaka A. Sugano K, Tack J, Kuipers EJ, et al. The quality assessment of the evidence was then used to determine the strength of the supporting evidence that informs a recommendation (Table 2).19, Level of Evidence and Strength of Recommendation. Although the prevalence of H. pylori is gradually decreasing, approximately half of the world's population still becomes infected with this disease. Meta-analysis of nine studies comparing bismuth quadruple therapy with other regimens after failure of first-line standard triple therapy. M-H, Mantel-Haenszel test; CI, confidence interval; PBMT, bismuth quadruple therapy; TT, standard triple therapy; SQT, sequential therapy; CCT, concomitant therapy. Furthermore, H. pylori chronic gastritis can induce decreasing gastric acid secretion and gastric ascorbic acid, which are essential for the absorption of dietary iron.25,26, H. pylori has been associated with IDA. Malfertheiner P, Chan FK, McColl KE. Eight recommendations were agreed upon for a total of 12 recommendations. Change in antibiotic resistance of Helicobacter pylori strains and the effect of A2143G point mutation of 23S rRNA on the eradication of H. pylori in a single center of Korea. Yee YK, Cheung TK, Chu KM, et al. Saad RJ, Schoenfeld P, Kim HM, Chey WD. Multi-center randomized controlled study to establish the standard third-line regimen for Helicobacter pylori eradication in Japan. In expert consensus based on these analyses, only 48.0% agreed in the first e-mail questionnaire, and only 63.3% agreed in the second face-to-face meeting. Until now, there were two RCTs about H. pylori eradication to prevent metachronous gastric cancer after ER of gastric tumors including EGC and adenoma (Supplementary Table 1).31-33 Three retrospective studies about H. pylori eradication after ER of gastric adenoma were reported.34-36 All of them were conducted in Korea. Its effect on acid and gastrin physiology. #mBio #Helicobacterpylori #Studie Can To overcome this, the treatment period has been extended or non-bismuth quadruple therapy such as sequential therapy or CT has been introduced. H. pylori Sequential therapy versus triple therapy for the first line treatment of Helicobacter pylori in Korea: a nationwide randomized trial. Absence of symptomatic benefit of lansoprazole, clarithromycin, and amoxicillin triple therapy in eradication of Helicobacter pylori positive, functional (nonulcer) dyspepsia. A meta-analysis of 24 RCTs (n=5,070) was conducted to confirm the effect on sequential therapy as the first-line treatment (Supplementary Table 4).75,77-80,90,94-111 Twenty RCTs compared comparing standard triple therapy, two RCTs comparing bismuth quadruple therapy, and two RCTs comparing hybrid therapy were included. The .gov means it’s official. Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis. Efficacy of two levofloxacin-containing second-line therapies for Helicobacter pylori: a pilot study. Received 2020 Sep 7; Revised 2020 Oct 14; Accepted 2020 Oct 20. Ang TL, Fock KM, Song M, et al. Meta-analysis of randomized controlled trials. However, there was a limitation that the number of patients included was small and no local studies were included. Munteanu D, Etzion O, Ben-Yakov G, et al. Chemoprevention of gastric dysplasia: randomized trial of antioxidant supplements and anti-Helicobacter pylori therapy. 8600 Rockville Pike and Upper Gastrointestinal Research. Sequential versus triple therapy for the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. eradication? A major limitation of levofloxacin triple therapy is that efficacy of the regimen is substantially reduced in the presence of levofloxacin resistance.162 In Korea, the resistance rate for levofloxacin in H. pylori strains has been increasing rapidly as high as 28.1%.14,182,183 Very recently, the nationwide antibiotic resistance profile of H. pylori in Korean population was reported.2 According to this report, resistance rate against levofloxacin was 37.0%. Hierfür stehen verschiedene Therapieregime bestehend aus Antibiotika und Protonenpumpeninhibitor (PPI) zur Verfügung (siehe Tabelle). 8). Symptomatic benefit from eradicating Helicobacter pylori infection in patients with nonulcer dyspepsia. What is the recommended salvage regimen after failure of previous Wie testet man Helicobacter pylori? Standard triple therapy (standard dose PPI, amoxicillin 1 g, and clarithromycin 500 mg twice daily) for 14 days is recommended for first-line regimen. Impact of quadruple regimen of clarithromycin added to metronidazole-containing triple therapy against Helicobacter pylori infection following clarithromycin-containing triple-therapy failure. A randomized control trial comparing 2 levofloxacin-containing second-line therapies for Helicobacter pylori eradication. Song MJ, Park DI, Park JH, et al. Treatment of Helicobacter pylori infection is important for the management of gastrointestinal disorders such as peptic ulcer and gastric cancer. 9). Javid G, Zargar SA, Bhat K, et al. Kim BG, Lee DH, Ye BD, et al. eradication? Fock KM, Graham DY, Malfertheiner P. Helicobacter pylori research: historical insights and future directions. Thus, it can be suggested that bismuth quadruple therapy and levofloxacin triple therapy may have similar efficacy when the two treatments are administered for the same duration. According to studies, H. pylori eradication is helpful to prevent metachronous recurrence after ER of gastric adenoma. The eradication rate of H. pylori in the tailored therapy group was 80.7% (176/218), which was significantly higher than that in the empirical 7-day standard triple therapy (69.5%, 214/308; p<0.01) or PAM (71.1%, 219/308; p=0.01) control groups in ITT analysis.82 In addition, the recent two case-control studies reported that 7-day tailored therapy with bismuth quadruple therapy, PAM, or standard triple therapy had higher eradication rates than those of empirical 7-day standard triple therapy (91.8% vs 72.1%; 94.3% vs 76.5%, respectively) in PP analysis.20,21 Importantly, the costs for a successful eradication with tailored therapy could be similar or superior to those of empirical 14-day standard triple therapy.21. Helicobacter pylori ist eine Bakterienart, die die Magenschleimhaut besiedeln kann. Karatapanis S, Skorda L, Georgopoulos S, et al. Die Besiedlung verläuft in vielen Fällen ohne Beschwerden, kann jedoch auch verschiedene Magenerkrankungen hervorrufen. Sardarian H, Fakheri H, Hosseini V, Taghvaei T, Maleki I, Mokhtare M. Comparison of hybrid and sequential therapies for Helicobacter pylori eradication in Iran: a prospective randomized trial. However, there was no statistically significant difference of ITT eradication rates in 10–14 days bismuth quadruple therapy compared to 14 days standard triple therapy (RR, 1.28; 95% CI, 0.97 to 1.70) (Fig. Aufgrund weltweit zunehmender Antibiotikaresistenzen werden zur effektiven Behandlung der H.-pylori-Infektion vermehrt Vierfachtherapien eingesetzt. Helicobacter pylori eradication prevents metachronous gastric neoplasms after endoscopic resection of gastric dysplasia. Liu WZ, Xie Y, Lu H, et al. Randomized controlled trials (RCTs) were evaluated using the Cochrane Risk of Bias (RoB) tool,16 while non-randomized clinical studies were assessed using the Risk of Bias Assessment Tool for Non-randomized Study (RoBANS).17 If the assessments were not consistent as the two paired working members, the two members and the chairman coordinated a final evaluation. There was no significant difference in the eradication rates between bismuth quadruple therapy and levofloxacin triple therapy in the meta-analysis of four RCTs. Guidelines for the management of Helicobacter pylori infection in Japan: 2009 revised edition. Effectiveness of three times daily lansoprazole/amoxicillin dual therapy for Helicobacter pylori infection in Korea. De novo method was implemented in this revision because the guidelines required the latest evidence as the dynamics of the H. pylori infection and related gastrointestinal diseases in Korea are changing rapidly.
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