Helicobacter pylori first-line and rescue treatments in patients allergic to penicillin: Experience from the European Registry on H pylori management (Hp-EuReg).
Anti-Bacterial Agents
/ therapeutic use
Bismuth
/ therapeutic use
Clarithromycin
/ therapeutic use
Drug Hypersensitivity
Drug Therapy, Combination
Helicobacter Infections
/ drug therapy
Helicobacter pylori
/ drug effects
Humans
Levofloxacin
/ therapeutic use
Metronidazole
/ therapeutic use
Penicillins
/ adverse effects
Prospective Studies
Proton Pump Inhibitors
/ therapeutic use
Registries
/ statistics & numerical data
Tetracycline
/ therapeutic use
Helicobacter pylori
allergic
allergy
bismuth
clarithromycin
levofloxacin
penicillin
Journal
Helicobacter
ISSN: 1523-5378
Titre abrégé: Helicobacter
Pays: England
ID NLM: 9605411
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
17
01
2020
revised:
08
02
2020
accepted:
10
02
2020
pubmed:
17
3
2020
medline:
4
11
2020
entrez:
17
3
2020
Statut:
ppublish
Résumé
Experience in Helicobacter pylori eradication treatment of patients allergic to penicillin is very scarce. A triple combination with a PPI, clarithromycin (C), and metronidazole (M) is often prescribed as the first option, although more recently the use of a quadruple therapy with PPI, bismuth (B), tetracycline (T), and M has been recommended. To evaluate the efficacy and safety of first-line and rescue treatments in patients allergic to penicillin in the "European Registry of H pylori management" (Hp-EuReg). A systematic prospective registry of the clinical practice of European gastroenterologists (27 countries, 300 investigators) on the management of H pylori infection. An e-CRF was created on AEG-REDCap. Patients with penicillin allergy were analyzed until June 2019. One-thousand eighty-four patients allergic to penicillin were analyzed. The most frequently prescribed first-line treatments were as follows: PPI + C + M (n = 285) and PPI + B + T + M (classic or Pylera In patients allergic to penicillin, a triple combination with PPI + C + M should not be generally recommended as a first-line treatment, while a quadruple regimen with PPI + B + T + M seems to be a better option. As a rescue treatment, this quadruple regimen (if not previously prescribed) or a triple regimen with PPI + C + L could be used but achieved suboptimal (<80%) results.
Sections du résumé
BACKGROUND
BACKGROUND
Experience in Helicobacter pylori eradication treatment of patients allergic to penicillin is very scarce. A triple combination with a PPI, clarithromycin (C), and metronidazole (M) is often prescribed as the first option, although more recently the use of a quadruple therapy with PPI, bismuth (B), tetracycline (T), and M has been recommended.
AIM
OBJECTIVE
To evaluate the efficacy and safety of first-line and rescue treatments in patients allergic to penicillin in the "European Registry of H pylori management" (Hp-EuReg).
METHODS
METHODS
A systematic prospective registry of the clinical practice of European gastroenterologists (27 countries, 300 investigators) on the management of H pylori infection. An e-CRF was created on AEG-REDCap. Patients with penicillin allergy were analyzed until June 2019.
RESULTS
RESULTS
One-thousand eighty-four patients allergic to penicillin were analyzed. The most frequently prescribed first-line treatments were as follows: PPI + C + M (n = 285) and PPI + B + T + M (classic or Pylera
CONCLUSION
CONCLUSIONS
In patients allergic to penicillin, a triple combination with PPI + C + M should not be generally recommended as a first-line treatment, while a quadruple regimen with PPI + B + T + M seems to be a better option. As a rescue treatment, this quadruple regimen (if not previously prescribed) or a triple regimen with PPI + C + L could be used but achieved suboptimal (<80%) results.
Substances chimiques
Anti-Bacterial Agents
0
Penicillins
0
Proton Pump Inhibitors
0
Metronidazole
140QMO216E
Levofloxacin
6GNT3Y5LMF
Tetracycline
F8VB5M810T
Clarithromycin
H1250JIK0A
Bismuth
U015TT5I8H
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12686Investigateurs
Jennifer Hinojosa
(J)
Nuria Fernández
(N)
Javier Molina Infante
(J)
Horacio Alonso Galán
(H)
Tommaso Di Maira
(T)
Susana Isabel Alves
(SI)
Sandra Saraiva
(S)
Luis Elvas
(L)
Daniel Brito
(D)
Ana Teresa Cadime
(A)
Polona Lampic
(P)
Aleksander Gruncic
(A)
Vid Leban
(V)
Luis Ferrer
(L)
Luis Fernandez Salazar
(L)
Angel Lanas
(A)
Vendel Kristensen
(V)
Stephan Brackmann
(S)
Jean Charles Delchier
(JC)
Charo Anton
(C)
Blas Jose Gomez Rodriguez
(BJ)
Rinaldo Pellicano
(R)
Doron Boltin
(D)
Informations de copyright
© 2020 John Wiley & Sons Ltd.
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