Helicobacter最新文献

{"title":"Advances in Helicobacter pylori Antimicrobial Resistance Detection: From Culture-Based to Multi-Omics-Based Technologies","authors":"Zupeng Kuang,&nbsp;Yuwei Wu,&nbsp;Xinqiang Xie,&nbsp;Xinyu Zhao,&nbsp;Huiyuan Chen,&nbsp;Lei Wu,&nbsp;He Gao,&nbsp;Hui Zhao,&nbsp;Tingting Liang,&nbsp;Jumei Zhang,&nbsp;Ying Li,&nbsp;Qingping Wu","doi":"10.1111/hel.70007","DOIUrl":"https://doi.org/10.1111/hel.70007","url":null,"abstract":"<div>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>), a proven carcinogenic microbe, necessitates antimicrobial treatment once infected. However, <i>H. pylori</i> worldwide currently faces serious antibiotic resistance (AMR), requiring infected patients to undergo antibiotic susceptibility testing (AST) to guide therapy. Currently, the recommended ASTs for <i>H. pylori</i> are culture-based methods, which are time-consuming, complicated, and expensive, impeding their widespread application. With in-depth researches on the AMR mechanisms of <i>H. pylori</i>, specific gene mutations and novel proteins have been confirmed as the cause of AMR and can serve as targets of ASTs. Accordingly, molecular biology detection has been developed and tremendously shortened the time and reduced difficulty of AST. However, these assays still struggle to meet the enormous testing demand and need for even faster, simpler, and more accurate methods. In recent years, researchers have developed various new platforms based on biosensors, transcriptomics, proteomics, and single-cell analysis. This review introduces the AMR mechanisms of <i>H. pylori</i> and summarizes the current ASTs from the working principles to application characteristics. Additionally, we draw attention to the potentially applicable techniques for AST of <i>H. pylori</i> from DNA, RNA, protein, and cell perspectives. By systematically recapitulating the past, present, and future of AST for <i>H. pylori</i>, this review provides valuable insights for developing novel assays.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement in Helicobacter pylori Eradication Among Adults Receiving Semaglutide: A Population-Based Propensity-Score-Adjusted Analysis","authors":"Asaf Ness,&nbsp;Zohar Levi,&nbsp;Rachel Gingold Belfer,&nbsp;Ram Dickman,&nbsp;Doron Boltin","doi":"10.1111/hel.70014","DOIUrl":"https://doi.org/10.1111/hel.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Glucagon-like peptide-1 (GLP-1) receptor agonists delay gastric emptying and are used for the treatment of diabetes (DM) and obesity. Successful treatment of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection depends upon a precise dosing schedule. We aimed to examine the impact of GLP-1 drugs on antibiotic treatment for <i>H. pylori</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults with a new diagnosis of <i>H. pylori</i> infection who received treatment between 2014 and 2023 were identified in the Clalit Health Services database. Subjects were divided into groups based on diagnoses of DM and obesity, and exposure to GLP-1 drugs. A 1:2 propensity-score matched dataset was used to determine the effect of GLP-1 drugs on eradication success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 426 individuals who received, and 36,436 who did not receive GLP-1 drugs. Eradication among those who did and did not receive GLP-1 drugs was 86.6% and 83.7%, respectively (<i>p =</i> 0.059 across subgroups). Eradication among those who received semaglutide was 93.8% (OR 2.78, 95% CI 1.32–5.83, <i>p</i> = 0.007). Eradication in subjects who received dulaglutide (88.6%) or liraglutide (81.4%) was not significantly changed. When applying a propensity-score-adjusted analysis, eradication remained significantly increased among individuals who received semaglutide (OR 2.89, 95% CI 1.24–6.74, <i>p</i> = 0.014). Additional independent predictors of successful eradication included male sex, high socioeconomic status, quadruple therapy, and older age (<i>p &lt;</i> 0.001 for all).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Co-administration of semaglutide and antibiotics for <i>H. pylori</i> infection is associated with an increased likelihood of successful eradication.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Rifabutin-Based Helicobacter pylori Eradication Regimen in Korea With High Prevalence of Tuberculosis Infection","authors":"Yuri Kim,&nbsp;Jeong Hoon Lee,&nbsp;Hee Kyong Na,&nbsp;Kee Wook Jung,&nbsp;Ji Yong Ahn,&nbsp;Do Hoon Kim,&nbsp;Kee Don Choi,&nbsp;Ho June Song,&nbsp;Gin Hyug Lee,&nbsp;Hwoon-Yong Jung","doi":"10.1111/hel.70011","DOIUrl":"https://doi.org/10.1111/hel.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As the antibiotic resistance and treatment failure rates of <i>Helicobacter pylori</i> are rising, the need for rescue therapy with rifabutin for <i>H. pylori</i> eradication (HPE) is also increasing. Therefore, in this study, we investigated the efficacy, resistance status, and adverse events in patients receiving rifabutin-based HPE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Between January 2020 and December 2022, 3006 patients underwent esophagogastroduodenoscopy (EGD) with <i>H. pylori</i> culture tests. Of these, culture results were successfully obtained from 1792 patients, who were subsequently enrolled in our study. The medical records of these patients were retrospectively reviewed, and their clinical features and outcomes assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 1792 patients, 14 (0.8%) were rifabutin-resistant. A total of 665 (37.1%) patients had multidrug-resistant (MDR) <i>H. pylori</i> infections. Patients with rifabutin-resistant <i>H. pylori</i> infections had a significantly higher rate of tuberculosis treatment history (2.8% vs. 28.6%, <i>p</i> &lt; 0.001) and MDR <i>H. pylori</i> infections (49.6% vs. 85.7%, <i>p</i> &lt; 0.001) than those in the rifabutin-susceptible <i>H. pylori</i> group. Among the 45 patients who received the rifabutin-based HPE regimen, 44 (97.8%) had MDR <i>H. pylori</i> infection, and 35 (77.8%) underwent rifabutin-based HPE as a third-line treatment or beyond. A total of 31 (68.9%) showed successful eradication. Nineteen (42.2%) patients experienced at least one symptom of adverse events; however, the severity of side effects was mild, and no patient discontinued treatment because of this.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The rifabutin-based HPE regimen could be an effective and safe treatment method. It is particularly considered a viable therapeutic option for patients who require HPE but have previously failed to respond to multiple HPEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Helicobacter pylori as an Infectious Disease: Implementation of Antimicrobial Stewardship","authors":"Jen-Yu Hsu,&nbsp;Un-In Wu,&nbsp;Jann-Tay Wang,&nbsp;Wang-Huei Sheng,&nbsp;Yee-Chun Chen,&nbsp;Shan-Chwen Chang","doi":"10.1111/hel.70013","DOIUrl":"10.1111/hel.70013","url":null,"abstract":"<div>\u0000 \u0000 <p><i>Helicobacter pylori</i> is prevalent globally and implicated in various gastric diseases and malignancies. Rising antibiotic resistance has increasingly compromised the effectiveness of standard <i>H. pylori</i> eradication therapies. This review explores the role of antimicrobial stewardship (AMS) as a structured approach to optimizing <i>H. pylori</i> management through the “5D” strategy: Diagnosis—utilizing advanced diagnostic tools to accurately detect bacterial resistance; Drug—selecting antibiotics tailored to resistance profiles and patient-specific factors; Dosage—optimizing dosing and frequency based on pharmacokinetic properties to maximize efficacy; Duration—employing shorter treatment courses where supported by evidence; and Discontinuation—balancing the benefits and risks of repeated antibiotic treatments. We discuss recent advances in diagnostic technologies, such as polymerase chain reaction and next-generation sequencing, and their impact on therapeutic decision-making. Additionally, we evaluate treatment regimens, with a particular focus on emerging alternatives such as regimens containing potassium-competitive acid blockers. Given the growing global resistance and limited pipeline for new antibiotics, we advocate for a more strategic and resource-conscious approach to <i>H. pylori</i> management, integrating AMS principles within the “One Health” framework to address the pathogen's transmission across humans, animals, and the environment. With advancements in resistance testing and diagnostics, <i>H. pylori</i> therapies are likely to become increasingly personalized and precise. To achieve this, effective AMS implementation necessitates interdisciplinary collaboration to maximize therapeutic outcomes, minimize adverse effects, combat resistance, and reduce healthcare costs.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should Metronidazole Be Included in Second-Line Treatment After Standard Triple Therapy for Helicobacter pylori?: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Hideki Mori,&nbsp;Toshihiro Nishizawa,&nbsp;Kohei Morioka,&nbsp;Motohiko Kato,&nbsp;Takanori Kanai","doi":"10.1111/hel.70010","DOIUrl":"10.1111/hel.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Although standard triple therapy remains the first-line eradication treatment for <i>H. pylori</i> worldwide, it is unclear whether metronidazole should be included empirically in second-line eradication treatments. The aim of this study was to compare the efficacy of metronidazole-containing regimens with that of metronidazole-free regimens after failure of first-line eradication using standard triple therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, the Cochrane Library, and the Igaku-Chuo-Zasshi database were searched to identify RCTs eligible for inclusion in this systematic review and meta-analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen eligible RCTs were included, with a total of 2039 patients assigned to metronidazole-containing (975 patients) or metronidazole-free (1064 patients) regimens. Metronidazole-containing regimens had significantly lower eradication failure rates than regimens without metronidazole (OR 0.55; 95% CI, 0.39–0.78). Subgroup analysis based on the regional risk of metronidazole resistance demonstrated that metronidazole-containing regimens had lower eradication failure rates not only in low-risk regions but also in high-risk regions (OR, 0.29; 95% CI, 0.11–0.74 and OR, 0.66; 95% CI, 0.49–0.91, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After failure of standard triple therapy, secondary eradication treatment regimens containing metronidazole demonstrate higher eradication rates than those without metronidazole.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic Inequity in the Current Approach to H. pylori Testing and Treatment: Linked Data Cohort Analysis","authors":"Andrea Teng,&nbsp;Erin Hildred,&nbsp;James Stanley,&nbsp;Stephen Inns,&nbsp;Melissa McLeod","doi":"10.1111/hel.70005","DOIUrl":"10.1111/hel.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As seen globally, there are up to sixfold differences in gastric cancer mortality by ethnicity in Aotearoa New Zealand, and <i>H. pylori</i> is the major modifiable risk factor<i>.</i> This study investigates whether current <i>H. pylori</i> testing and treatment approaches are equitable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The study design was a retrospective cohort analysis of linked administrative health data. Laboratory testing data and pharmacy dispensing were linked to the Northern region health user population dataset (1.9 million) from 2015 to 2018. We investigated an individual's first test for <i>H. pylori</i>. Regression analyses compared ethnic differences in rates of <i>H. pylori</i> testing, infection, treatment, and retesting, adjusted for age, sex, and calendar year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ethnic inequities were present across the clinical pathway. Compared to sole-European, testing rates were lowest in Māori (OR 0.69) and Pacific (OR 0.81) and highest in Middle-Eastern/Latin-American/African (MELAA) (OR 2.21) and Asian (OR 2.02). Positivity rates were highest in MELAA (RR 2.96, 39%) and Pacific (RR 2.84, 38%) followed by Asian (RR 1.93, 26%) and Māori (RR 1.71, 23%). Treatment rates were similar for Asian (HR 1.05), MELAA (HR 1.03), and Māori (HR 0.98) compared to sole-European but lower in Pacific (HR 0.90). Māori and Pacific were half as likely to be retested as sole-European.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite the higher prevalence of <i>H. pylori</i> and gastric cancer, Māori and Pacific are relatively underserved with lower rates of testing and treatment than sole-European. Improved guidelines and the consistent application of these along with an equity-focused test and treat program are likely to be particularly beneficial for Māori and Pacific in addressing inequities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combatting Helicobacter pylori: A Focus on Nanomaterials","authors":"Xuanping Wang,&nbsp;Xihui Felicia Chan,&nbsp;Yuyo Go,&nbsp;Yishen Wang,&nbsp;Tingyu Li,&nbsp;Gangshi Wang","doi":"10.1111/hel.70004","DOIUrl":"10.1111/hel.70004","url":null,"abstract":"<div>\u0000 \u0000 <p>Developing effective non-antibiotic antimicrobial strategies is essential for combating global antibiotic resistance, including resistance stemming from <i>Helicobacter pylori</i> (<i>H. pylori</i>) treatment. Nanomaterials offer a promising and innovative approach for non-antibiotic anti-<i>H. pylori</i> treatment strategies. This review highlights the progress made in the use of metallic and nonmetallic nanoparticles, as well as nanozymes, to directly inhibit <i>H. pylori</i> growth. Moreover, we summarize advances made in the direct targeting of <i>H. pylori</i> by nanomaterials and the stimuli-responsive release of nanoparticles in the stomach. Additionally, we explore the recent advancements in multifunctional nanoplatforms that integrate physical methods, such as light, heat, ultrasound, and magnetism, with nanomaterials to synergistically treat <i>H. pylori</i> infections. Finally, we briefly address the existing challenges and future directions in this field. In summary, we highlight that with ongoing research, nanomaterials may serve as a promising treatment strategy for <i>H. pylori</i> eradication.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Lactobacillus spp. Supplementation in Helicobacter pylori Eradication: A Systematic Meta-Analysis of Randomized Controlled Trials With Trial Sequential Analysis","authors":"Vivek Mishra,&nbsp;Debabrata Dash,&nbsp;Aditya K. Panda,&nbsp;Sushil Kumar Pathak","doi":"10.1111/hel.70006","DOIUrl":"10.1111/hel.70006","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;&lt;i&gt;Helicobacter pylori&lt;/i&gt; infection is a major global health concern and has been associated with a number of gastrointestinal disorders. Probiotics, especially &lt;i&gt;Lactobacillus&lt;/i&gt; spp., have been suggested to have beneficial effect in managing &lt;i&gt;H. pylori&lt;/i&gt; infection. This meta-analysis of randomized control trials (RCTs) aimed to evaluate the effect of &lt;i&gt;Lactobacillus&lt;/i&gt; spp. supplementation on &lt;i&gt;H. pylori&lt;/i&gt; eradication rates and associated side effects when combined with standard therapy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Materials and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Relevant studies were retrieved from PubMed, Scopus, Google Scholar and the Cochrane Library. Comprehensive Meta-Analysis (CMA) Software 4.0 was used for all the statistical analyses. TSA 0.9.5.10 Beta software was used for the trial sequential analysis (TSA). GRADEpro GDT was used to assess the certainty of evidence.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;An analysis of 26 selected studies showed that supplementing with &lt;i&gt;Lactobacillus&lt;/i&gt; spp. significantly increased the rates of &lt;i&gt;H. pylori&lt;/i&gt; eradication in per-protocol (PP) analysis (Overall risk ratio [RR] = 1.063, &lt;i&gt;p&lt;/i&gt; = 0.000, 95% CI of −0.21 to 2.11; adults: RR = 1.050, &lt;i&gt;p&lt;/i&gt; = 0.005, 95% CI = −0.55 to 2.03, children: RR = 1.223, &lt;i&gt;p&lt;/i&gt; = 0.001, 95% CI = −13.35 to 4.55). In comparison to quadruple therapy, &lt;i&gt;Lactobacillus&lt;/i&gt; spp. supplementation to triple therapy showed significant benefit (RR: 1.124; &lt;i&gt;p&lt;/i&gt; = 0.000, 95% CI of −0.48 to 2.61). &lt;i&gt;L. reuteri&lt;/i&gt; supplementation indicated better efficacy (RR: 1.049; &lt;i&gt;p&lt;/i&gt; = 0.055, 95% CI of −0.56 to 3.26) than &lt;i&gt;Lactobacillus&lt;/i&gt; GG (RR: 0.980; &lt;i&gt;p&lt;/i&gt; = 0.595, 95% CI of −0.69 to 1.21). The 28–30 day (RR: 1.103; &lt;i&gt;p&lt;/i&gt; = 0.003, 95% CI of −2.14 to 4.19) and 14-day supplementation periods (RR: 1.102; p = 0.003, 95% CI of −1.69 to 3.51) showed the most improvement. The analysis also revealed that &lt;i&gt;Lactobacillus&lt;/i&gt; spp. significantly reduced gastrointestinal side effects: nausea/vomiting (RR: 0.566; &lt;i&gt;p&lt;/i&gt; = 0.037, −3.11 to 1.45), diarrhea (RR: 0.324; &lt;i&gt;p&lt;/i&gt; = 0.000, −5.46 to 0.48), and abdominal pain (RR: 0.438; &lt;i&gt;p&lt;/i&gt; = 0.007, −5.65 to 4.22). The effect on bloating was non-significant (RR: 0.820; &lt;i&gt;p&lt;/i&gt; = 0.498, −4.01 to 0.96). TSA graphs validated sufficient evidence for the conclusions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;&lt;i&gt;Lactobacillus&lt;/i&gt; spp. significantly enhances &lt;i&gt;H. pylori&lt;/i&gt; eradication rates and may reduce gastrointestinal side effects when used alongside standard therapy, offering a promising adjunctive treatment option. The evidence was supported by TSA and asse","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Macrolide Exposure on Tailored Helicobacter pylori Eradication Therapy and Antibiotic Resistance Profiles: A Prospective Study Using the Drug Utilization Review System","authors":"Jin Hee Noh,&nbsp;Kee Don Choi,&nbsp;Hee Kyong Na,&nbsp;Ji Yong Ahn,&nbsp;Jeong Hoon Lee,&nbsp;Kee Wook Jung,&nbsp;Do Hoon Kim,&nbsp;Ho June Song,&nbsp;Gin Hyug Lee,&nbsp;Hwoon-Yong Jung","doi":"10.1111/hel.70003","DOIUrl":"https://doi.org/10.1111/hel.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Determining antibiotic use history accurately is challenging due to its reliance on patient recall. By determining macrolide exposure using the Korean drug utilization review (DUR) system, we analyzed the impact of previous macrolide use on antibiotic resistance profiles and compared the eradication rate between tailored therapy based on macrolide exposure history and empirical therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with confirmed <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection who agreed to access prescription information using the Health Insurance Review and Assessment Service DUR system were enrolled between 2021 and 2023. Patients received tailored therapy, which was clarithromycin (CLR)-based triple therapy in cases without macrolide exposure and bismuth quadruple (BQ) therapy in cases with macrolide exposure. The empirical therapy group was prospectively recruited at the same time to compare the eradication rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 418 patients (tailored therapy group, <i>n</i> = 57; empirical therapy group, <i>n</i> = 361) were analyzed. Among the tailored therapy group, 24.6% took macrolide antibiotics for the past 5 years. CLR resistance rates were higher in patients with previous macrolide use than in those without (66.7% vs. 7.5%, <i>p</i> &lt; 0.001). The tailored therapy group showed a higher eradication rate than the empirical therapy group for intention-to-treat (ITT), modified intention-to-treat (MITT), and per-protocol (PP) analyses (ITT, 86.0% vs. 75.6%; MITT, 94.2% vs. 80.3%; PP, 94.2% vs. 85.1%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Previous macrolide exposure identified using the DUR system was associated with a higher rate of CLR resistance. Tailored therapy based on macrolide exposure history led to higher eradication rates compared to empirical therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142764097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori Infection in Children: To Eradicate or Not to Eradicate?","authors":"Marco Manfredi,&nbsp;Madhur Ravikumara","doi":"10.1111/hel.70002","DOIUrl":"https://doi.org/10.1111/hel.70002","url":null,"abstract":"<div>\u0000 \u0000 <p><i>Helicobacter pylori</i> infection is usually acquired during childhood and represents one of the most common infections in humans. It is well known that <i>H. pylori</i> has belonged to humankind for hundreds of thousands of years and it accompanied the human migration from Africa. The adult international guidelines recommend treating all infected patients as <i>H. pylori</i> was classified among the first-class human carcinogens by the WHO in 1994 and it is one of the main factors involved in the development of gastric cancer. Conversely, the pediatric international guidelines are more restrictive in recommending the eradication of the infection in children. Although many studies have shown evidence regarding the pathological role of <i>H. pylori</i> regardless of the age of the infected patients, many others have highlighted its protective/positive role in several extra-gastric diseases in children. In this review, both points of view regarding the eradication in children are critically analyzed.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}