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Zhang Z, Liu F, Ai F, Chen X, Liu R, Zhang C, Fang N, Fu T, Wang X, Tang A. The efficacy and mechanism of vonoprazan-containing triple therapy in the eradication of Helicobacter pylori. Front Pharmacol 2023; 14:1143969. [PMID: 37214450 PMCID: PMC10196117 DOI: 10.3389/fphar.2023.1143969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/07/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose: Vonoprazan (VPZ) produces a strong acid-inhibitory effect, which can potentially eradicate Helicobacter Pylori (H. pylori). We aimed to assess whether a 14-day VPZ-containing triple therapy was safe and effective in the Chinese population and the potential mechanism. Methods: Enrolled patients confirmed to be infected with H. pylori were randomly divided into four groups: VPZ + doxycycline + furazolidone, VPZ + doxycycline + amoxicillin, esomeprazole (EPZ) + bismuth + doxycycline + furazolidone, and EPZ + colloidal bismuth + doxycycline + amoxicillin for 14 days. The eradication rate, medication adherence, and incidence of adverse events (AEs) were evaluated. Inhibition of H. pylori by VPZ and EPZ in vitro was assessed. H. pylori treated with appropriate concentrations of VPZ and EPZ were sequenced by transcriptome analysis to explore the antibacterial mechanism. Results: A higher eradication rate were observed in VPZ-containing triple therapy. No obvious differences were observed in medication adherence or the incidence of AEs. VPZ had no direct inhibitory effect on H. pylori, whereas EPZ directly inhibited H. pylori may through downregulated genes related to the ribosome. Conclusion: In the Chinese population, 14-day VPZ-containing triple therapy was safe and more effective and can be used clinically as first-line H. pylori treatment. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT05097846.
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Affiliation(s)
- Zinan Zhang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fen Liu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Central South University, Changsha, Hunan, China
| | - Feiyan Ai
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Central South University, Changsha, Hunan, China
| | - Xiong Chen
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Rui Liu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chao Zhang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ning Fang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Tian Fu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaoyan Wang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Central South University, Changsha, Hunan, China
| | - Anliu Tang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Central South University, Changsha, Hunan, China
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Bordin DS, Voynovan IN, Sarsenbaeva AS, Zaytsev OV, Abdulkhakov RA, Bakulina NV, Bakulin IG, Osipenko MF, Livzan MA, Alekseenko SA, Tarasova LV, Tarasova GN, Bogomolov PO, Maev IV, Andreev DN, Abdulkhakov SR, Starostin BD, Bakanova NV, Kononova AG, Kolbasnikov SV, Bueverova EL, Moreira L, Megraud F, O'Morain C, Perez Nyssen O, Gisbert J. [Effectiveness of empirical Helicobacter pylori eradication therapy with furazolidone in Russia: results from the European Registry on Helicobacter pylori Management (Hp-EuReg)]. TERAPEVT ARKH 2023; 95:120-129. [PMID: 37167127 DOI: 10.26442/00403660.2023.02.202107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND First-line therapy does not always provide a high level of Helicobacter pylori eradication due to the increase of H. pylori resistance to antibiotics; therefore, it remains necessary to identify the most effective rescue treatments. The purpose of this study was to evaluate the efficacy and safety of empirical H. pylori furazolidone-containing regimens. MATERIALS AND METHODS Adult H. pylori infected patients empirically treated with furazolidone-containing eradication regimens were registered in an international, prospective, multicenter non-intervention European registry on H. pylori management (Hp-EuReg). Data were collected at AEG-REDCap e-CRF from 2013 to 2021 and the quality was reviewed. Modified intention-to-treat (mITT) effectiveness analyses were performed. RESULTS Overall 106 patients received empirical furazolidone-containing therapy in Russia. Furazolidone was prescribed in a sequential scheme along with amoxicillin, clarithromycin and a proton pump inhibitor in 68 (64%) cases, triple regimens were prescribed in 28 (26%) patients and quadruple regimens in 10 (9.4%). Treatment duration of 7 days was assigned to 2 (1.9%) patients, 10-day eradication therapy in case of 80 (75%) and 14 days - in 24 (23%) patients. Furazolidone was mainly used in first- (79%) and second-line (21%) regimens. The methods used to diagnose H. pylori infection were: histology (81%), stool antigen test (64%), 13C-urea breath test (6.6%), and rapid urease test (1.9%). The mITT effectiveness of sequential therapy was 100%; 93% with the triple therapy and 75.5% with quadruple therapy. Compliance was reported in 98% of cases. Adverse events were revealed in 5.7% of patients, mostly nausea (3.8%). No serious adverse events were reported. CONCLUSION Furazolidone containing eradication regimens appear to be an effective and safe empirical therapy in Russia.
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Affiliation(s)
- D S Bordin
- Loginov Moscow Clinical Scientific Center
- Yevdokimov Moscow State University of Medicine and Dentistry
- Tver State Medical University
| | | | | | | | | | - N V Bakulina
- Mechnikov North-Western State Medical University
| | - I G Bakulin
- Mechnikov North-Western State Medical University
| | | | | | | | | | | | - P O Bogomolov
- Yevdokimov Moscow State University of Medicine and Dentistry
- Private Medical Center "Universal"
- Vladimirsky Moscow Regional Clinical Research Institute
| | - I V Maev
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - D N Andreev
- Yevdokimov Moscow State University of Medicine and Dentistry
| | | | | | | | | | | | - E L Bueverova
- Sechenov First Moscow State Medical University (Sechenov University)
| | - L Moreira
- Hospital Clínic de Barcelona
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd)
- University of Barcelona
| | | | | | - O Perez Nyssen
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
- Universidad Autónoma de Madrid (UAM)
| | - J Gisbert
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
- Universidad Autónoma de Madrid (UAM)
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Somnath, Ahmad M, Siddiqui KA. Ratiometric luminescent sensing of a biomarker for sugar consumption in an aqueous medium using a Cu(II) coordination polymer. Dalton Trans 2023; 52:3643-3660. [PMID: 36867431 DOI: 10.1039/d3dt00022b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
An innovative [Cu(Hadp)2(Bimb)]n (KA@CP-S3) coordination polymer expands its dimensionality from a 1D chain to a 2D network. The topological analysis reveals that KA@CP-S3 has 2-connected uninodal 2D 2C1 topology. KA@CP-S3 has capable luminescent sensing for volatile organic compounds (VOCs), nitroaromatics, heavy metal ions, anions, disposed antibiotics (nitrofurantoin and tetracycline) and biomarkers. Intriguingly, KA@CP-S3 exhibits outstanding selective quenching of about 90.7% and 90.5% for the 125 mg dl-1 and 150 mg dl-1 strengths of sucrose, respectively, in aqueous solution along with other ranges in between. The photocatalytic degradation efficiency of KA@CP-S3 for the potentially harmful organic dye Bromophenol Blue displays 95.4%, which is the highest among the 13 dyes that were evaluated.
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Affiliation(s)
- Somnath
- Department of Chemistry, National Institute of Technology Raipur, G E Road, Raipur-492010, Chhattisgarh, India.
| | - Musheer Ahmad
- Department of Applied Chemistry, Faculty of Engineering and Technology, ZHCET, Aligarh Muslim University, Aligarh, UP, 202002, India
| | - Kafeel Ahmad Siddiqui
- Department of Chemistry, National Institute of Technology Raipur, G E Road, Raipur-492010, Chhattisgarh, India.
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Bhuvaneswari C, Ganesh Babu S. Nanoarchitecture and surface engineering strategy for the construction of 3D hierarchical CuS-rGO/g-C3N4 nanostructure: An ultrasensitive and highly selective electrochemical sensor for the detection of furazolidone drug. J Electroanal Chem (Lausanne) 2022. [DOI: 10.1016/j.jelechem.2022.116080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rizwan M, Selvanathan V, Rasool A, Qureshi MAUR, Iqbal DN, Kanwal Q, Shafqat SS, Rasheed T, Bilal M. Metal-Organic Framework-Based Composites for the Detection and Monitoring of Pharmaceutical Compounds in Biological and Environmental Matrices. WATER, AIR, AND SOIL POLLUTION 2022; 233:493. [PMID: 36466935 PMCID: PMC9685123 DOI: 10.1007/s11270-022-05904-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/13/2022] [Indexed: 05/10/2023]
Abstract
The production of synthetic drugs is considered a huge milestone in the healthcare sector, transforming the overall health, aging, and lifestyle of the general population. Due to the surge in production and consumption, pharmaceutical drugs have emerged as potential environmental pollutants that are toxic with low biodegradability. Traditional chromatographic techniques in practice are time-consuming and expensive, despite good precision. Alternatively, electroanalytical techniques are recently identified to be selective, rapid, sensitive, and easier for drug detection. Metal-organic frameworks (MOFs) are known for their intrinsic porous nature, high surface area, and diversity in structural design that provides credible drug-sensing capacities. Long-term reusability and maintaining chemo-structural integrity are major challenges that are countered by ligand-metal combinations, optimization of synthetic conditions, functionalization, and direct MOFs growth over the electrode surface. Moreover, chemical instability and lower conductivities limited the mass commercialization of MOF-based materials in the fields of biosensing, imaging, drug release, therapeutics, and clinical diagnostics. This review is dedicated to analyzing the various combinations of MOFs used for electrochemical detection of pharmaceutical drugs, comprising antibiotics, analgesics, anticancer, antituberculosis, and veterinary drugs. Furthermore, the relationship between the composition, morphology and structural properties of MOFs with their detection capabilities for each drug species is elucidated.
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Affiliation(s)
- Muhammad Rizwan
- Department of Chemistry, University of Lahore, Lahore, 54000 Punjab Pakistan
| | - Vidhya Selvanathan
- Solar Energy Research Institute (SERI), Universiti Kebangsaan Malaysia (UKM), 43600 Bangi, Selangor Darul Ehsan Malaysia
| | - Atta Rasool
- School of Chemistry, University of the Punjab, Lahore, Pakistan
| | | | - Dure Najaf Iqbal
- Department of Chemistry, University of Lahore, Lahore, 54000 Punjab Pakistan
| | - Qudsia Kanwal
- Department of Chemistry, University of Lahore, Lahore, 54000 Punjab Pakistan
| | - Syed Salman Shafqat
- Department of Chemistry, Division of Science and Technology, University of Education, Lahore, 54000 Pakistan
| | - Tahir Rasheed
- Interdisciplinary Research Centre for Advanced Materials, King Fahd University of Petroleum and Minerals (KFUPM), Dhahran, 31261 Saudi Arabia
| | - Muhammad Bilal
- Institute of Chemical Technology and Engineering, Faculty of Chemical Technology, Poznan University of Technology, Berdychowo 4, 60695 Poznan, PL Poland
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Lutsenko IA, Yambulatov DS, Kiskin MA, Nelyubina YV, Primakov PV, Bekker OB, Levitskiy OA, Magdesieva TV, Imshennik VK, Maksimov YV, Sidorov AA, Danilenko VN, Eremenko IL. Improved In Vitro Antimycobacterial Activity of Trinuclear Complexes Cobalt(II,III) and Iron(III) with 2‐Furoic Acid against
Mycolicibacterium smegmatis. ChemistrySelect 2020. [DOI: 10.1002/slct.202003101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Irina A. Lutsenko
- N. S. Kurnakov Institute of General and Inorganic Chemistry of the Russian Academy of Sciences Leninsky prosp. 31 119991 Moscow Russian Federation
| | - Dmitriy S. Yambulatov
- N. S. Kurnakov Institute of General and Inorganic Chemistry of the Russian Academy of Sciences Leninsky prosp. 31 119991 Moscow Russian Federation
| | - Mikhail A. Kiskin
- N. S. Kurnakov Institute of General and Inorganic Chemistry of the Russian Academy of Sciences Leninsky prosp. 31 119991 Moscow Russian Federation
| | - Yulia V. Nelyubina
- A. N. Nesmeyanov Institute of Organoelement Compounds Russian Academy of Sciences Vavilova Str. 28 119991 Moscow Russian Federation
| | - Petr V. Primakov
- A. N. Nesmeyanov Institute of Organoelement Compounds Russian Academy of Sciences Vavilova Str. 28 119991 Moscow Russian Federation
| | - Olga B. Bekker
- Vavilov Institute of General Genetics of the Russian Academy of Sciences Gubkina Str. 3 119991 Moscow Russian Federation
| | - Oleg A. Levitskiy
- Lomonosov Moscow State University Leninskie Gory 1/3 119991 Moscow Russian Federation
| | - Tatiana V. Magdesieva
- Lomonosov Moscow State University Leninskie Gory 1/3 119991 Moscow Russian Federation
| | - Vladimir K. Imshennik
- N. N. Semenov Institute of Chemical Physics, Russian Academy of Sciences Kosygina Str. 4 119991 Moscow Russian Federation
| | - Yurii V. Maksimov
- N. N. Semenov Institute of Chemical Physics, Russian Academy of Sciences Kosygina Str. 4 119991 Moscow Russian Federation
| | - Aleksey A. Sidorov
- N. S. Kurnakov Institute of General and Inorganic Chemistry of the Russian Academy of Sciences Leninsky prosp. 31 119991 Moscow Russian Federation
| | - Valery N. Danilenko
- Vavilov Institute of General Genetics of the Russian Academy of Sciences Gubkina Str. 3 119991 Moscow Russian Federation
| | - Igor L. Eremenko
- N. S. Kurnakov Institute of General and Inorganic Chemistry of the Russian Academy of Sciences Leninsky prosp. 31 119991 Moscow Russian Federation
- A. N. Nesmeyanov Institute of Organoelement Compounds Russian Academy of Sciences Vavilova Str. 28 119991 Moscow Russian Federation
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Antibacterial action of (5-nitrofurfuryl)-derived aminophosphonates and their parent imines. CHEMICAL PAPERS 2019. [DOI: 10.1007/s11696-018-0597-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Reaction of 1-(het)aryl-3-bromoprop-2-ynones with furans in solid metal oxides or salts: cross-coupling or cycloaddition? MENDELEEV COMMUNICATIONS 2018. [DOI: 10.1016/j.mencom.2018.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Hajaghamohammadi A, Safiabadi Tali SH, Samimi R, Oveisi S, Kazemifar AM. Low dose furazolidone for eradication of H- pylori instead of clarithromycin: a clinical trial. Glob J Health Sci 2014; 7:235-9. [PMID: 25560342 PMCID: PMC4796360 DOI: 10.5539/gjhs.v7n1p235] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 06/27/2014] [Indexed: 12/28/2022] Open
Abstract
Background: Helicobacter pylori infection is a common chronic human bacterial infection. Triple- therapy regimen containing a proton pump inhibitor, clarithromycin, and either amoxicillin or metronidazole is commonly used as first-line treatment for its eradication. However, it may not provide the acceptable eradication rate. The present study was designed to evaluated efficacy of low dose furazolidone with amoxicillin and omeprazole for eradication of H. pylori. Materials and Methods: One hundred twenty patients with non- ulcer dyspepsia or peptic ulcer confirmed by upper GI endoscopy, plus H. pylori infection confirmed by rapid urease test were included in the study. They were randomly divided into two groups, and then received clarithromycin, amoxicillin, and omeprazole, or furazolidone (100 mg PO bid), amoxicillin, and omeprazole. They were evaluated using urea breath test at the end of the study. Findings: The eradication rates were 57.6% and 78.8% in clarithromycin and furazolidone groups, respectively. Their difference was statistically significant (P value 0.013). No side effect was seen in the furazolidone group. Conclusion: Low dose furazolidone rather than clarithromycin can be used as low- cost and effective drug for eradication of H. pylori, in combination with amoxicillin and omeprazole.
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Abstract
In most South American countries, Helicobacter pylori infection prevalence is high, affecting over 70% in populations with precarious living conditions. It is worth pointing out that there is initial evidence of a decline in prevalence of H. pylori infection at least in some more privileged fragments of the population. It is estimated that gastric cancer, the main clinical sequela of H. pylori infection, has an average incidence rate of 12.4 cases per 100,000 inhabitants (8.4 cases per 100,000 inhabitants for women and 17.3 cases per 100,000 for men) in the region. Classical triple therapy [proton pump inhibitor (PPI), amoxicillin and clarithromycin] is still the most used regimen with eradication rates around 80%. The rates of resistance to clarithromycin range from 2 to 24%. Recurrence rates of the infection are described as 2.9% in Argentina, 4.2% in Chile, 2-7% in Brazil, and 11.5% in a trial involving 7 Latin American countries. After failure of clarithromycin-containing regimens, second- and third-line therapies using PPI, amoxicillin and levofloxacin and quadruple therapy with PPI, colloidal bismuth subcitrate, tetracycline hydrochloride and metronidazole are recommended. Due to the high rates of primary resistance to metronidazole in the Latin American countries, use of the quadruple therapy, replacing metronidazole for furazolidone, is a frequent option. Rescue triple therapy regimens using furazolidone in association with levofloxacin and PPI have also been used. Most recommended rescue therapies reach eradication rates close to 80%.
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Affiliation(s)
- Luiz Gonzaga Coelho
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Ierardi E, Giorgio F, Losurdo G, Di Leo A, Principi M. How antibiotic resistances could change Helicobacter pylori treatment: A matter of geography? World J Gastroenterol 2013; 19:8168-8180. [PMID: 24363506 PMCID: PMC3857438 DOI: 10.3748/wjg.v19.i45.8168] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 10/18/2013] [Accepted: 11/05/2013] [Indexed: 02/06/2023] Open
Abstract
Therapeutic management of Helicobacter pylori (H. pylori) remains an unsolved issue. Indeed, no therapeutic regimen is able to cure the infection in all treated patients, and in many the infection persists despite the administration of several consecutive standard therapies. Although antibiotic resistance reports describe alarming results, the outcome of therapeutic regimens does not seem to parallel this scenario in most cases, since a successful performance is often reached in more than 80% of cases. However, the phenomenon of increasing antibiotic resistance is being closely studied, and the results show controversial aspects even in the same geographic area. For the continents of Europe, America, Asia, Africa, and Oceania, minimal and maximal values of resistance to the main antibiotics (clarithromycin, amoxicillin, metronidazole, and levofloxacin) feature wide ranges in different countries. The real enigma is therefore linked to the several different therapeutic regimens, which show results that often do not parallel the in vitro findings even in the same areas. A first aspect to be emphasized is that some regimens are limited by their use in very small geographic districts. Moreover, not all therapeutic trials have considered bacterial and host factors affecting the therapeutic outcome. The additional use of probiotics may help to reduce adverse events, but their therapeutic impact is doubtful. In conclusion, the “ideal therapy”, paradoxically, appears to be a “utopia”, despite the unprecedented volume of studies in the field and the real breakthrough in medical practice made by the discovery and treatment of H. pylori. The ample discrepancies observed in the different areas do not encourage the development of therapeutic guidelines that could be valid worldwide. On these bases, one of the main challenges for the future might be identifying a successful solution to overcome antibiotic resistances. In this context, geography must be considered a relevant matter.
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High Helicobacter pylori resistance to metronidazole and clarithromycin in Brazilian children and adolescents. J Pediatr Gastroenterol Nutr 2013; 56:645-8. [PMID: 23403439 DOI: 10.1097/mpg.0b013e31828b3669] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of the present study was to assess the primary and secondary resistance of Helicobacter pylori strains to clarithromycin, amoxicillin, furazolidone, tetracycline, and metronidazole, the conventional antibiotics presently used in Brazilian children and adolescents. METHODS Seventy-seven consecutive H pylori strains, 71 of 77 strains obtained from patients without previous eradication treatment for H pylori infection, and 6 strains from patients in whom previous eradication treatment had failed. RESULTS Global rate of resistance was 49.3% (38/77): 40% of strains were resistant to metronidazole, 19.5% to clarithromycin, and 10.4% to amoxicillin. All of the tested H pylori strains were susceptible to furazolidone and tetracycline. Multiple resistance were detected in 18.2% (14/77 patients) of the strains: 6 of 14 (43%) simultaneously resistant to clarithromycin and metronidazole; 5 of 14 (36%) to amoxicillin and metronidazole; 2 of 14 (14%) to amoxicillin, clarithromycin, and metronidazole; and 1 of 14 (7%) to clarithromycin and amoxicillin. CONCLUSIONS The high resistance rate to metronidazole and clarithromycin observed in clinical H pylori isolates can exclude these antimicrobials in empirical eradication treatment in Brazil. Otherwise, furazolidone and tetracycline presented no resistance. Properly assessing the risks and benefits, these 2 antimicrobials and their derivatives could be used in empirical eradication schedules, both associated with amoxicillin, which showed a low resistance rate despite its wide use in pediatric patients.
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Coelho LG, Maguinilk I, Zaterka S, Parente JM, do Carmo Friche Passos M, Moraes-Filho JPP. 3rd Brazilian Consensus on Helicobacter pylori. ARQUIVOS DE GASTROENTEROLOGIA 2013; 50:S0004-28032013005000113. [PMID: 23748591 DOI: 10.1590/s0004-28032013005000001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 02/14/2013] [Indexed: 12/11/2022]
Abstract
Signicant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.
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Affiliation(s)
- Luiz Gonzaga Coelho
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Zullo A, Ierardi E, Hassan C, Francesco VD. Furazolidone-based therapies for Helicobacter pylori infection: a pooled-data analysis. Saudi J Gastroenterol 2012; 18:11-7. [PMID: 22249086 PMCID: PMC3271687 DOI: 10.4103/1319-3767.91729] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 10/22/2011] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIM Furazolidone-based therapies are used in developing countries to cure Helicobacter pylori infection due to its low cost. The low bacterial resistance toward furazolidone may render appealing the use of this drug even in developed countries. However, some relevant safety concerns do exist in using furazolidone. PATIENTS AND METHODS This was a systematic review with pooled-data analysis of data regarding both eradication rate and safety of furazolidone-based therapies for H. pylori infection. Intention-to-treat (ITT) and per-protocol (PP) eradication rates were calculated. RESULTS Following furazolidone-based first-line therapy, H. pylori eradication rates were 75.7% and 79.6% at ITT and PP analysis, respectively (P<0.001). The overall incidence of side effects and severe side effects were 33.2% and 3.8%, respectively. At multivariate analysis, only high-dose furazolidone was associated with increased therapeutic success (OR: 1.5, 95% CI: 1.3-2.7; P<0.001), while occurrence of side effects was relevant following treatment for a long duration (OR: 2.9, 95% CI: 2.2-4.1; P<0.001), high-dose furazolidone (OR: 2.3, 95% CI: 1.7-3.2; P<0.001) and bismuth-containing regimens (OR: 2.1, 95% CI: 1.5-2.8; P<0.001). CONCLUSIONS Furazolidone-based regimens usually achieve low eradication rates. Only a high-dose regimen improves the cure rate, but simultaneously increases the incidence of severe side effects. Therefore, we suggest that patients have to be clearly informed about the possible genotoxic and carcinogenetic effects for which furazolidone use is not approved in developed countries.
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Affiliation(s)
- Angelo Zullo
- Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Enzo Ierardi
- Gastroenterology and Digestive Endoscopy, ‘Nuovo Regina Margherita’ Hospital, Rome, Italy
| | - Cesare Hassan
- Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Vincenzo De Francesco
- Gastroenterology and Digestive Endoscopy, ‘Nuovo Regina Margherita’ Hospital, Rome, Italy
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