☆ 4.6 Review

Treatment of Helicobacter pylori Infection in Patients with Penicillin Allergy

ANTIBIOTICS-BASEL (2023)

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Article Pharmacology & Pharmacy

Effectiveness and safety of vonoprazan-based regimens compared with those of proton pump inhibitor (PPI)-based regimens as first-line agents for Helicobacter pylori: a meta-analysis of randomized clinical trials

Yingchao Sun et al.

Summary: This study found that Vonoprazan-based regimens had a superior eradication efficacy compared to PPI-based regimens for Helicobacter pylori infection. The tolerability and incidence of adverse events were similar between the two regimens.

EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY (2023)

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Article Gastroenterology & Hepatology

A real-world exploratory study on the feasibility of vonoprazan and tetracycline dual therapy for the treatment of Helicobacter pylori infection in special populations with penicillin allergy or failed in previous amoxicillin-containing therapies

Wen Gao et al.

Summary: This study evaluated the eradication rate and adverse effects of vonoprazan and tetracycline dual therapy as first-line and rescue treatment regimens for special populations with penicillin allergy or failed in previous amoxicillin-containing therapies. The results showed that this combination therapy was effective and safe in treating Helicobacter pylori infection in special populations.

HELICOBACTER (2023)

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Article Medicine, General & Internal

A Vonoprazan, Clarithromycin, and Metronidazole Regimen as Helicobacter pylori Eradication Therapy for Patients with Penicillin Allergy in Light of Clarithromycin Resistance

Kazunori Adachi et al.

Summary: This study assessed the efficacy of a vonoprazan (VPZ), clarithromycin (CAM), and metronidazole (MNZ) regimen in treating Helicobacter pylori infection in patients with clarithromycin resistance (CAM-R) and penicillin allergy. The results showed that the VCM regimen had a eradication rate of 94.3% and was effective for all patients with clarithromycin sensitivity (CAM-S). For patients with CAM-R, the success rate was 90.9%. Therefore, the VCM regimen may be a viable treatment option for patients with penicillin allergy, regardless of clarithromycin resistance.

INTERNAL MEDICINE (2023)

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Review Pharmacology & Pharmacy

Vonoprazan With Amoxicillin or Amoxicillin and Clarithromycin for the Treatment of Helicobacter pylori Infection

Ligang Liu et al.

Summary: This article reviews the pharmacology, efficacy, safety, and potential role of vonoprazan in combination with amoxicillin or amoxicillin and clarithromycin for the treatment of Helicobacter pylori infection in adults. The study findings suggest that vonoprazan-based therapy is more effective than proton-pump inhibitor (PPI)-based therapy and provides prolonged acid inhibition. This presents an important alternative treatment option for adult patients with H. pylori infection.

ANNALS OF PHARMACOTHERAPY (2023)

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Review Infectious Diseases

The Efficacy and Safety of Vonoprazan and Amoxicillin Dual Therapy for Helicobacter pylori Infection: A Systematic Review and Network Meta-Analysis

Ligang Liu et al.

Summary: The eradication of Helicobacter pylori (H. pylori) infection is challenging due to increasing bacterial resistance. Vonoprazan triple therapy (VAC) has shown similar efficacy and safety compared to PPI-based therapy, but the efficacy of vonoprazan dual therapy (VA) is poorly established. Six studies comparing VA, VAC, and PPI were analyzed, and VAC was found to be the most effective therapy, followed by VA and PPI. VA ranked first in terms of safety. These findings have important implications for selecting the most effective and safe treatment for H. pylori infection.

ANTIBIOTICS-BASEL (2023)

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Article Food Science & Technology

Application of minocycline in patients with Helicobacter pylori infection allergic to penicillin

Lingyun Zhang et al.

Summary: The study found that minocycline-based bismuth quadruple therapies have an ideal eradication rate and minimal side effects for patients with penicillin allergy and Hp infection.

FOOD SCIENCE AND TECHNOLOGY (2022)

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Review Gastroenterology & Hepatology

Helicobacter pylori Antibiotic Resistance in the United States Between 2011 and 2021: A Systematic Review and Meta-Analysis

Jonathan J. C. Ho et al.

Summary: Antimicrobial resistance among Helicobacter pylori strains has been increasing globally, with metronidazole, levofloxacin, and clarithromycin resistance rates exceeding 30% in the United States between 2011 and 2021. It is important to consider antibiotic resistance patterns when choosing an empiric antibiotic regimen. Resistance to tetracycline, rifabutin, and amoxicillin remains low. Continued surveillance and systematic data collection are crucial for effective H. pylori management.

AMERICAN JOURNAL OF GASTROENTEROLOGY (2022)

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Article Medicine, General & Internal

Prevalence of drug allergy in South Australia

Carlo Yuson et al.

Summary: The study investigated the prevalence of self-reported drug allergy in the general adult population in South Australia. It found that 22% of adults considered themselves allergic to one or more drugs, with penicillin allergy being the most common. Drug and penicillin allergies were more prevalent in females and increased with age.

INTERNAL MEDICINE JOURNAL (2022)

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Article Gastroenterology & Hepatology

Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report

Peter Malfertheiner et al.

Summary: Helicobacter pylori infection is recognized as an infectious disease and requires optimized management to prevent complications and gastric cancer. Continuous updates in treatment strategies and testing methods are necessary due to rising antibiotic resistance and the impact on gut microbiota.

GUT (2022)

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Review Microbiology

Empirical vs. Susceptibility-Guided Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis

Olga P. Nyssen et al.

Summary: The meta-analysis comparing empirical vs. susceptibility-guided treatment of H. pylori infection showed that there was no demonstrated benefit of susceptibility-guided treatment over empirical treatment, whether in first-line (with updated quadruple regimens) or in rescue therapies.

FRONTIERS IN MICROBIOLOGY (2022)

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Review Allergy

Differences in beta-lactam and penicillin allergy: Beyond the West and focusing on Asia-Pacific

Hugo W. F. Mak et al.

Summary: This review discusses the contrasting global epidemiology, shifting clinical practices, and disparities of β-lactam antibiotic allergy in the Asia-Pacific region compared with the West. Innovative strategies to overcome barriers in β-lactam allergy workup are discussed, along with potential directions for future research and service development.

FRONTIERS IN ALLERGY (2022)

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Article Gastroenterology & Hepatology

Chinese Consensus Report on Family-Based Helicobacter pylori Infection Control and Management (2021 Edition)

Song-Ze Ding et al.

Summary: Experts discussed and modified 23 original statements on family-based H. pylori infection transmission, control and management, and reached consensus on 16 statements. The final report consists of three parts: H. pylori infection and transmission among family members, prevention and management of H. pylori infection in children and elderly people within households, and strategies for prevention and management of H. pylori infection for family members. In addition to the 'test-and-treat' and 'screen-and-treat' strategies, this consensus also introduced a novel third 'family-based H. pylori infection control and management' strategy to prevent its intrafamilial transmission and development of related diseases.

GUT (2022)

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Article Gastroenterology & Hepatology

Helicobacter pylori Eradication Rates in Slovenia in the Period from 2017 to 2019: Data from the European Registry on H. pylori Management

Bojan Tepes et al.

Summary: In Slovenia, H. pylori eradication treatments showed optimal effectiveness with a 14-day triple therapy of PPI plus two antibiotics, especially for patients allergic to penicillin and those with clarithromycin resistance. The ten-day quadruple-bismuth second-line therapy yielded better results compared to the 14-day triple therapy with levofloxacin, showing 100% effectiveness in a small sample size.

DIGESTIVE DISEASES (2021)

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Article Microbiology

Outpatient Fluoroquinolone Prescription Fills in the United States, 2014 to 2020: Assessing the Impact of Food and Drug Administration Safety Warnings

Deanna J. Buehrle et al.

Summary: Outpatient fluoroquinolone prescription fills in the United States significantly decreased from 2015 to 2019, with the most notable decline observed following the FDA warnings in May 2016. FDA safety warnings prove to be effective in reducing outpatient antimicrobial usage.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2021)

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Review Allergy

Skin Testing for Penicillin Allergy: a Review of the Literature

Tracy Zembles et al.

Summary: Self-reported penicillin allergies are often not true allergies, leading to unnecessary use of alternative antibiotics. Risk stratification assessment is important in optimizing antibiotic use and preventing emergence of antimicrobial resistance.

CURRENT ALLERGY AND ASTHMA REPORTS (2021)

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Article Gastroenterology & Hepatology

Comparative Effectiveness of Multiple Different First-Line Treatment Regimens for Helicobacter pylori Infection: A Network Meta-analysis

Theodore Rokkas et al.

Summary: The study compared the effectiveness of different first-line regimens for Helicobacter pylori infection through a network meta-analysis. Results showed that vonoprazan triple therapy and reverse hybrid therapy achieved high eradication rates above 90%, with levofloxacin triple therapy performing best in Western countries. Standard triple therapy was found to be the least efficacious in this analysis.

GASTROENTEROLOGY (2021)

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Article Gastroenterology & Hepatology

Helicobacter pylori resistance to antibiotics in Europe in 2018 and its relationship to antibiotic consumption in the community

Francis Megraud et al.

Summary: The study confirmed a positive correlation between macrolide and quinolone consumption in the community and corresponding H. pylori resistance in European countries. Therefore, treatment of H. pylori with clarithromycin and levofloxacin should involve susceptibility testing in most European countries before starting the treatment.

GUT (2021)

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Review Gastroenterology & Hepatology

Helicobacter pylori infection and antibiotic resistance - from biology to clinical implications

Evariste Tshibangu-Kabamba et al.

Summary: Helicobacter pylori is a major human pathogen with increasing antibiotic resistance posing a serious threat to human health. The resistance mechanisms include single drug resistance, multidrug resistance, and heteroresistance, primarily related to mutational changes and target-mediated mechanisms. Further research is needed to explore additional biological attributes driving drug resistance in H. pylori for better treatment outcomes.

NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY (2021)

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Review Pharmacology & Pharmacy

Metronidazole-induced Metallic Taste: A Systematic Review and Meta-Analysis

Hani Raka Karrar et al.

Summary: The meta-analysis showed that the incidence rate of metallic taste adverse effects was slightly higher in patients treated with tinidazole compared to metronidazole. However, the overall difference was not statistically significant, suggesting that shifting patients to metronidazole may lead to a slight decrease in metallic taste incidence rate.

JOURNAL OF PHARMACEUTICAL RESEARCH INTERNATIONAL (2021)

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Review Gastroenterology & Hepatology

Susceptibility-guided versus empirical treatment for Helicobacter pylori infection: A systematic review and meta-analysis

Rachel Gingold-Belfer et al.

Summary: The study suggests that susceptibility-guided treatment may be slightly superior to empirical first-line triple therapy for previously untreated Helicobacter pylori infection. However, susceptibility-guided treatment does not appear to be superior to empirical first-line quadruple therapy or empirical rescue therapy.

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2021)

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Review Medicine, General & Internal

Sitafloxacin for Third-Line Helicobacter pylori Eradication: A Systematic Review

Toshihiro Nishizawa et al.

Summary: This study reviewed 12 clinical studies and found that the vonoprazan-sitafloxacin-amoxicillin regimen is a good option for third-line Helicobacter pylori eradication treatment, although extending the treatment duration may further improve eradication rates. Confirmation of drug susceptibility before using sitafloxacin is recommended due to safety concerns related to fluoroquinolones.

JOURNAL OF CLINICAL MEDICINE (2021)

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Article Gastroenterology & Hepatology

Helicobacter pylori rescue treatment with vonoprazan, metronidazole, and sitafloxacin in the presence of penicillin allergy

Soichiro Sue et al.

Summary: The study demonstrates that the 7-day VPZ-MNZ-STFX rescue therapy has a high eradication rate of H. pylori in patients with penicillin allergy, with good tolerability, particularly in terms of completing the medication course.

JGH OPEN (2021)

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Article Gastroenterology & Hepatology

Susceptibility-guided therapy for Helicobacter pylori-infected penicillin-allergic patients: A prospective clinical trial of first-line and rescue therapies

Luo Laisheng et al.

HELICOBACTER (2020)

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Article Gastroenterology & Hepatology

Helicobacter pylori first-line and rescue treatments in patients allergic to penicillin: Experience from the European Registry on H pylori management (Hp-EuReg)

Olga P. Nyssen et al.

HELICOBACTER (2020)

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Article Gastroenterology & Hepatology

Guidelines for the management of Helicobacter pylori infection in Japan: 2016 Revised Edition

Mototsugu Kato et al.

HELICOBACTER (2019)

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Cefuroxime, levofloxacin, esomeprazole, and bismuth as first-line therapy for eradicating Helicobacter pylori in patients allergic to penicillin

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BMC GASTROENTEROLOGY (2019)

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PHARMACOTHERAPY (2019)

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Evaluation and Management of Penicillin Allergy A Review

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JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2019)

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY (2019)

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Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection

M. Zamani et al.

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Bismuth improves efficacy of proton-pump inhibitor clarithromycin, metronidazole triple Helicobacter pylori therapy despite a high prevalence of antimicrobial resistance

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Tetracycline, metronidazole and amoxicillin-metronidazole combinations in proton pump inhibitor-based triple therapies are equally effective as alternative therapies against Helicobacter pylori infection

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Article Gastroenterology & Hepatology

Helicobacter pylori first-line treatment and rescue options in patients allergic to penicillin

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High eradication rates of Helicobacter pylori infection with first- and second-line combination of esomeprazole, tetracycline, and metronidazole in patients allergic to penicillin

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