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Antibiotics
Special Issues
Helicobacter pylori Infection: Therapy Changes and Challenges
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Helicobacter pylori Infection: Therapy Changes and Challenges

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: closed (15 November 2022) | Viewed by 12551

Special Issue Editor

Dr. Chia-Jung Kuo

E-Mail Website
Guest Editor
1. Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
2. College of Medicine, Chang Gung University, Taoyuan, Taiwan
3. Chang Gung Microbiota Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
Interests: peptic ulcer disease; gastric cancer; inflammatory bowel disease; Helicobacter pylori

Special Issue Information

Dear Colleagues,

Helicobacter pylori is a well-known pathogen associated with several upper gastrointestinal tract diseases, including peptic ulcer disease, atrophic gastritis, and gastric malignancies. The possible causes for eradication therapy failures include antibiotic resistance, smoking, high bacterial load before treatment, bacterial genotype, and polymorphisms of metabolism of PPIs. The successful rate of eradication of H. pylori has recently declined, mainly due to the increasing prevalence of drug resistance. With the changing profile of H. pylori antibiotic resistance, optimizing the therapy for H. pylori infection has become challenging.

Dr. Chia-Jung Kuo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • H. pylori infection
  • antibiotic resistance
  • multi-drug resistance
  • precision medicine
  • eradication
  • first-line
  • rescue
  • susceptibility test

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Published Papers (3 papers)

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Research

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13 pages, 1268 KiB  
Article
Management of Helicobacter Pylori Infection and Effectiveness Rates in Daily Clinical Practice in Spain: 2010–2019
by Inés Ariño Pérez, Samuel J. Martínez-Domínguez, Enrique Alfaro Almajano, Patricia Carrera-Lasfuentes and Ángel Lanas
Antibiotics 2022, 11(5), 698; https://doi.org/10.3390/antibiotics11050698 - 20 May 2022
Cited by 7 | Viewed by 2781
Abstract
The management and effectiveness of the treatment of Helicobacter pylori infection are heterogeneous worldwide, despite the publication of international consensus conferences and guidelines, which have been widely available for years. The aim of the study was to describe the clinical management and the [...] Read more.
The management and effectiveness of the treatment of Helicobacter pylori infection are heterogeneous worldwide, despite the publication of international consensus conferences and guidelines, which have been widely available for years. The aim of the study was to describe the clinical management and the eradication rates in a region of Southern Europe (Spain). Between 2010 and 2019, we conducted a retrospective analysis of patients with H. pylori infection attended by gastroenterologists in two defined areas of the National Health System in Aragón. We compared the appropriateness of therapies according to guidelines, and described the effectiveness of each treatment. A total of 1644 penicillin non-allergic patients were included. The most prescribed therapy between 2010 and 2013 was the ‘classic’ triple therapy PCA (80%), whereas the ’concomitant’ therapy PCAM was chosen by 90% of the gastroenterologists in 2015. After 2016, the use of the quadruple bismuth-containing therapy in a single capsule (Pylera®) quickly increased, representing almost half of the overall prescriptions in 2019. Throughout the decade, adherence to guidelines was 76.4% and global efficacy was 70.7% (ITT). Triple therapies’ eradication rates were lower than 70% (ITT), whereas eradication rates with quadruple therapies achieved or were over 80% (ITT). In conclusion, despite the use of quadruple therapies and optimized treatments, the effectiveness of H. pylori management in daily clinical practice is far from the target of 90%. Full article
(This article belongs to the Special Issue Helicobacter pylori Infection: Therapy Changes and Challenges)
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Review

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16 pages, 1001 KiB  
Review
Treatment of Pediatric Helicobacter pylori Infection
by Hung-Hsiang Lai and Ming-Wei Lai
Antibiotics 2022, 11(6), 757; https://doi.org/10.3390/antibiotics11060757 - 1 Jun 2022
Cited by 16 | Viewed by 6374
Abstract
Helicobacter pylori infection can cause gastritis, gastric or duodenal ulcers, mucosa-associated lymphoid tissue lymphoma, gastric cancer, and extra-gastrointestinal manifestations. Ideal treatment should be guided by antibiotic susceptibility testing. However, this is not feasible in many regions, so the treatment generally relies on clinical [...] Read more.
Helicobacter pylori infection can cause gastritis, gastric or duodenal ulcers, mucosa-associated lymphoid tissue lymphoma, gastric cancer, and extra-gastrointestinal manifestations. Ideal treatment should be guided by antibiotic susceptibility testing. However, this is not feasible in many regions, so the treatment generally relies on clinical experience and regional culture sensitivity profiles. We aimed to integrate the treatment of pediatric H. pylori infection through a systematic literature review. Databases including PubMed, Cochrane Library, EMBASE, and Scholar were searched using terms containing (Helicobacter OR Helicobacter pylori OR H. pylori) AND (child OR pediatric) for all relevant manuscripts and guidelines, published from January 2011 to December 2021. The eradication rate for pediatric H. pylori infection was not satisfactory using triple therapy, sequential therapy, concomitant therapy, bismuth-based quadruple therapy, or adjuvant therapy with probiotics as the first-line therapy. Most therapies could not achieve the recommended eradication rate of >90%, which may be attributed to varying regional antibiotic resistance and possible poor children’s compliance. More studies are required to establish a best practice for pediatric H. pylori infection treatment. Full article
(This article belongs to the Special Issue Helicobacter pylori Infection: Therapy Changes and Challenges)
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Other

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7 pages, 384 KiB  
Brief Report
Empiric “Three-in-One” Bismuth Quadruple Therapy for Second-Line Helicobacter pylori Eradication: An Intervention Study in Southern Italy
by Giuseppe Losurdo, Ilaria Lacavalla, Francesco Russo, Giuseppe Riezzo, Irene Vita Brescia, Maria Rendina, Enzo Ierardi and Alfredo Di Leo
Antibiotics 2022, 11(1), 78; https://doi.org/10.3390/antibiotics11010078 - 10 Jan 2022
Cited by 7 | Viewed by 2463
Abstract
The eradication of Helicobacter pylori (H. pylori) may be difficult due to antibiotic resistance. Indeed, after one failure, a second-line therapy is needed and a bismuth containing quadruple therapy (BQT) with a three-in-one capsule formulation is becoming very popular. Therefore, we [...] Read more.
The eradication of Helicobacter pylori (H. pylori) may be difficult due to antibiotic resistance. Indeed, after one failure, a second-line therapy is needed and a bismuth containing quadruple therapy (BQT) with a three-in-one capsule formulation is becoming very popular. Therefore, we aimed to evaluate effectiveness and safety of BQT as a second-line therapy. We recruited consecutive patients with one therapy failure. For ten days patients received the three-in-one BQT Pylera® therapy, in combination with a proton-pump inhibitor (PPI), decided at the choice of the investigator, at full dose bid. The eradication rate was calculated by intention-to-treat (ITT) and per-protocol (PP)analyses and 95% confidence intervals (CI) were calculated. Seventy-three patients were recruited, 41 females and 32 males (mean age 53.0±13.1 years). Fifty-five patients failed triple therapy with amoxicillin and clarithromycin and the remaining 18 received sequential therapy. Seventy-two patients consumed at least 90% of the capsules, while only one did not complete the therapy due to adverse events (nausea and diarrhea). By ITT analysis, BQT was successful in 62 subjects (eradication rate 84.9%, 95%CI 76.7–93.1%). By PP analysis, the eradication rate was 86.1% (95%CI 78.1–94.1%).Adverse events were observed in 14 subjects (20.5%).In conclusion, our report confirmed that BQT is effective as an empiric second-line regimen. Full article
(This article belongs to the Special Issue Helicobacter pylori Infection: Therapy Changes and Challenges)
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