AI Article Synopsis
- - National and international increases in resistance to antimicrobials for treating Helicobacter pylori (H. pylori), particularly high clarithromycin resistance levels in Ireland, necessitated a reassessment of treatment strategies.
- - The Irish H. pylori working group (IHPWG) conducted a review using the 'GRADE' approach to develop updated management recommendations based on the latest research findings.
- - Key recommendations include using bismuth quadruple therapy as the first-line treatment in unclear or confirmed clarithromycin resistance cases, and reserving clarithromycin triple therapy for cases with confirmed susceptibility, along with specific strategies for second-line and rescue therapies.
Article Abstract
Background: There has been an increase in resistance to many of the antimicrobials used to treat Helicobacter pylori ( H. pylori ) nationally and internationally. Primary clarithromycin resistance and dual clarithromycin and metronidazole resistance are high in Ireland. These trends call for an evaluation of best-practice management strategies.
Objective: The objective of this study was to revise the recommendations for the management of H. pylori infection in adult patients in the Irish healthcare setting.
Methods: The Irish H. pylori working group (IHPWG) was established in 2016 and reconvened in 2023 to evaluate the most up-to-date literature on H. pylori diagnosis, eradication rates and antimicrobial resistance. The 'GRADE' approach was then used to rate the quality of available evidence and grade the resulting recommendations.
Results: The Irish H. pylori working group agreed on 14 consensus statements. Key recommendations include (1) routine antimicrobial susceptibility testing to guide therapy is no longer recommended other than for clarithromycin susceptibility testing for first-line treatment (statements 6 and 9), (2) clarithromycin triple therapy should only be prescribed as first-line therapy in cases where clarithromycin susceptibility has been confirmed (statement 9), (3) bismuth quadruple therapy (proton pump inhibitor, bismuth, metronidazole, tetracycline) is the recommended first-line therapy if clarithromycin resistance is unknown or confirmed (statement 10), (4) bismuth quadruple therapy with a proton pump inhibitor, levofloxacin and amoxicillin is the recommended second-line treatment (statement 11) and (5) rifabutin amoxicillin triple therapy is the recommend rescue therapy (statement 12).
Conclusion: These recommendations are intended to provide the most relevant current best-practice guidelines for the management of H. pylori infection in adults in Ireland.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11198963 | PMC |
| http://dx.doi.org/10.1097/MEG.0000000000002796 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Helicobacter pylori and its role in the pathogenesis of follicular gastritis: an overview.
Rev Gastroenterol Peru
January 2025
Infectious Diseases and Cancer Research Group, Centro de Investigaciones Clinicas, Fundacion Hospital San Pedro, Pasto, Nariño, Colombia; Colombian Research Group on Helicobacter pylori, Bogota D.C., Colombia.
The role of Helicobacter pylori in the pathogenesis of peptic ulcers and gastric adenocarcinoma is widely known; however, it is not entirely understood how bacterial infection is closely related to the genesis of follicular gastritis and some types of gastric lymphoma. Diagnosing and pathogenic mechanisms follicular gastritis remain challenging. Therefore, this article aims to examine the role of H.
View Article and Find Full Text PDF[An update of the Helicobacter pylori treatment: a Latin American Gastric Cancer, Helicobacter and Microbiota Study Group review].
Rev Gastroenterol Peru
January 2025
Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Helicobacter pylori (H. pylori) is the primary etiological agent of gastric adenocarcinoma, which affects over 60% of the global population, with a significant prevalence in Latin America. Given its impact on the affected population, it is crucial to understand the diagnostic tools available for detecting this infection.
View Article and Find Full Text PDF[Treatment of Helicobacter pylori infection in the era of antibiotic resistance. What do we know?].
Rev Gastroenterol Peru
January 2024
Unidad Motilidad Digestiva, Clínica San Felipe, Lima, Perú; Servicio de Gastroenterología Clínica Ricardo Palma, Lima, Perú; Universidad Peruana Cayetano Heredia, Lima, Perú.
M cells targeted H. pylori antigen SAM-FAdE displayed on bacterium-like particles induce protective immunity.
J Nanobiotechnology
January 2025
School of First Clinical Medical, Ningxia Medical University, Yinchuan, 750004, China.
Background: Helicobacter pylori (H. pylori), a specific bacterium capable of surviving in the acidic environment of the stomach, has been recognized as a group of causative agents of gastric cancer. Therefore, the development of mucosal vaccines against H.
View Article and Find Full Text PDFEradication Therapy to Prevent Gastric Cancer in H. pylori-positive individuals: Systematic Review and Meta-analysis of Randomized Controlled Trials and Observational Studies.
Gastroenterology
January 2025
Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Background & Aims: Screening for, and treating, Helicobacter pylori (H. pylori) in the general population or patients with early gastric neoplasia could reduce incidence of, and mortality from, gastric cancer. We updated a meta-analysis of randomized controlled trials (RCTs) examining this issue.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!