Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 Apr 1;119(4):646-654.
doi: 10.14309/ajg.0000000000002600. Epub 2023 Nov 17.

Effectiveness of Helicobacter pylori Treatments According to Antibiotic Resistance

Luis Bujanda  1 , Olga P Nyssen  2 , June Ramos  1 , Dmitry S Bordin  3 , Bojan Tepes  4 , Angeles Perez-Aisa  5 , Matteo Pavoni  6 , Manuel Castro-Fernandez  7 , Frode Lerang  8 , Mārcis Leja  9 , Luis Rodrigo  10 , Theodore Rokkas  11 , Juozas Kupcinskas  12 , Laimas Jonaitis  12 , Oleg Shvets  13 , Antonio Gasbarrini  14 , Halis Simsek  15 , Perminder S Phull  16 , György Miklós Buzás  17 , Jose C Machado  18 , Doron Boltin  19 , Lyudmila Boyanova  20 , Ante Tonkić  21 , Wojciech Marlicz  22 , Marino Venerito  23 , Ludmila Vologzanina  24 , Galina D Fadieienko  25 , Giulia Fiorini  6 , Elena Resina  2 , Raquel Muñoz  2 , Anna Cano-Català  26 , Ignasi Puig  27 , Natalia García-Morales  28 , Luis Hernández  29 , Leticia Moreira  30 , Francis Megraud  31 , Colm O Morain  32 , Milagrosa Montes  33 , Javier P Gisbert  2 ; Hp-EuReg investigators; Hp-EuReg investigators
Collaborators, Affiliations
Multicenter Study

Effectiveness of Helicobacter pylori Treatments According to Antibiotic Resistance

Luis Bujanda et al. Am J Gastroenterol. .

Abstract

Introduction: Antibiotic resistance is one of the main factors that determine the efficacy of treatments to eradicate Helicobacter pylori infection. Our aim was to evaluate the effectiveness of first-line and rescue treatments against H. pylori in Europe according to antibiotics resistance.

Methods: Prospective, multicenter, international registry on the management of H. pylori (European Registry on H. pylori Management). All infected and culture-diagnosed adult patients registered in the Spanish Association of Gastroenterology-Research Electronic Data Capture from 2013 to 2021 were included.

Results: A total of 2,852 naive patients with culture results were analyzed. Resistance to clarithromycin, metronidazole, and quinolones was 22%, 27%, and 18%, respectively. The most effective treatment, regardless of resistance, were the 3-in-1 single capsule with bismuth, metronidazole, and tetracycline (91%) and the quadruple with bismuth, offering optimal cure rates even in the presence of bacterial resistance to clarithromycin or metronidazole. The concomitant regimen with tinidazole achieved an eradication rate of 99% (90/91) vs 84% (90/107) with metronidazole. Triple schedules, sequential, or concomitant regimen with metronidazole did not achieve optimal results. A total of 1,118 non-naive patients were analyzed. Resistance to clarithromycin, metronidazole, and quinolones was 49%, 41%, and 24%, respectively. The 3-in-1 single capsule (87%) and the triple therapy with levofloxacin (85%) were the only ones that provided encouraging results.

Discussion: In regions where the antibiotic resistance rate of H. pylori is high, eradication treatment with the 3-in-1 single capsule, the quadruple with bismuth, and concomitant with tinidazole are the best options in naive patients. In non-naive patients, the 3-in-1 single capsule and the triple therapy with levofloxacin provided encouraging results.

Trial registration: ClinicalTrials.gov NCT02328131.

PubMed Disclaimer

References

    1. Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of Helicobacter pylori infection: Systematic review and meta- analysis. Gastroenterology 2017;153(2):420–9.
    1. Lanas A, Chan FKL. Peptic ulcer disease. Lancet 2017;390(10094):613–24.
    1. WHO. Antibiotics Resistance Report ( https://www.who.int/es/news-room/fact-sheets/detail/resistencia-a-los-an... ) (2022).
    1. WHO. WHO Publishes List of Bacteria for Which New Antibiotics Are Urgently Needed ( https://www.who.int/es/news/item/27-02-2017-who-publishes-list-of-bacter... ) (2017).
    1. Gisbert JP, Alcedo J, Amador J, et al. V Spanish Consensus Conference on Helicobacter pylori infection treatment. Gastroenterol Hepatol 2022;45(5):392–417.

Publication types

Associated data

LinkOut - more resources