Naslov
Effectiveness of treatments against Helicobacter pylori according to resistance to clarithromycin: data from the European registry on Helicobacter pylori management (HP-EUREG)

Autori
L. Bujanda Fernández de Piérola, O. Perez Nyssen, J. Ramos, D.S. Bordin, B. Tepeš, Á. Pérez-Aísa, B. Vaira, M. Caldas Álvarez, M. Castro Fernandez, F. Lerang, M. Leja, L.R. Rodrigo Sáez, T. Rokkas, L. Kupcinskas, J. Perez-Lasala, L. Jonaitis, O. Shvets, A. Gasbarrini, I. Simsek, P. Phull, G.M. Buzás, J.C.L. Machado, Y. Niv, L. Boyanova, E.D. Dobru, V. Lamy, Ante Tonkić, W. Marlicz, C. Beglinger, M. Venerito, P. Bytzer, L. Capelle, T. Milosavljevic, L. Vologhzanina, G. Fadeenko, G. Fiorini, E. Resina Sierra, R. Muñoz González, A. Cano-Catalá, I. Puig, F. Mégraud, C. O‘Morain, J. Gisbert

Kolaboracija
Hp-EuReg Investigators

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
United European Gastroenterology Journal 10(2022)S8 / - , 2022, 370-370

Skup
30th United European Gastroenterology Week

Mjesto i datum
Beč, Austrija, 08.10.2022. - 11.10.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Helicobacter pylori ; clarithromycin ; resistance

Sažetak
Introduction: Antibiotic resistance is the main factor influencing the ef-ficacy of treatments to eradicate the infection by Helicobacter pylori (H. pylori). The treatments including clarithromycin are the most frequently used in first-line ; however, the bacterial resistance to clarithromycin in treatment-naïve patients in Europe is, overall, >20%.Aims & Methods: To assess the effectiveness of first-line H. pylori treat- ments in Europe according to the resistance to clarithromycin.Non-interventional, prospective, multicenter, international European re-gistry on the management of H. pylori (Hp-EuReg). All culture-diagnosed infected adult patients were registered at AEG-REDCap e-CRF from 2013 to 2021. Per-protocol (PP) analysis was performed based on the presence or absence of bacterial resistance to clarithromycin in treatment-naïve pati-ents. The data was subject to quality control.Results: In total, 2, 479 culture-naïve patients were included. Of these, 627 (25%) reported resistance to clarithromycin. The eradication rate with the standard triple therapy (PPI+clarithromycin+amoxicillin) in patients susceptible to clarithromycin was 92% (424/460). The eradication rate in these clarithromycin-susceptible patients was higher both with the con-comitant regimen (PPI+clarithromycin+amoxicillin+metronidazole) and with the sequential treatment with tinidazole (95%, 882/929), and also with the bismuth quadruple regimen (PPI+bismuth+tetracycline+metronidazole) as single capsule (100%, 67/67) (p<0.05). In those patients with bacterial resistance to clarithromycin, the effectiveness of the standard triple therapy decreased to 75% (9/12), and the eradication rate with the concomitant and sequential regimen was 87% (314/361 ; p<0.05) ; while the effectiveness with the single- capsule bismuth-containing quadruple was 93%. Conclusion:In those European regions where the H. pylori resistance rate to clarithromycin is high, therapy with the bismuth quadruple regimen is the best eradication option. Other alternatives that approach 90% eradi-cation despite clarithromycin resistance are the non-bismuth quadruple concomitant and sequential regimens.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA