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The second Irish Helicobacter pylori Working Group consensus for the diagnosis and treatment of Helicobacter pylori infection in adult patients in Ireland.
Smith, Sinéad M; Boyle, Breida; Buckley, Martin; Costigan, Conor; Doyle, Maeve; Farrell, Richard; Ismail, M Syafiq; Kevans, David; Nugent, Sean; O'Connor, Anthony; O'Morain, Colm; Parihar, Vikrant; Ryan, Cristín; McNamara, Deirdre.
Afiliación
  • Smith SM; School of Medicine, Trinity College Dublin.
  • Boyle B; Department of Clinical Microbiology, St. James's Hospital, Dublin.
  • Buckley M; Department of Gastroenterology, Mercy University Hospital, Cork.
  • Costigan C; School of Medicine, Trinity College Dublin.
  • Doyle M; Department of Gastroenterology, Tallaght University Hospital, Dublin.
  • Farrell R; Department of Microbiology, University Hospital Waterford, Waterford.
  • Ismail MS; Department of Gastroenterology, Connolly Hospital, RCSI, Dublin.
  • Kevans D; Department of Gastroenterology, Cavan and Monaghan Hospital.
  • Nugent S; School of Medicine, Trinity College Dublin.
  • O'Connor A; Department of Gastroenterology, St. James's Hospital, Dublin.
  • O'Morain C; Department of Gastroenterology, Whitfield Clinic, Waterford.
  • Parihar V; School of Medicine, Trinity College Dublin.
  • Ryan C; Department of Gastroenterology, Tallaght University Hospital, Dublin.
  • McNamara D; School of Medicine, Trinity College Dublin.
Eur J Gastroenterol Hepatol ; 36(8): 1000-1009, 2024 Aug 01.
Article en En | MEDLINE | ID: mdl-38829956
ABSTRACT

BACKGROUND:

There has been an increase in resistance to many of the antimicrobials used to treat Helicobacter pylori ( H. pylori ) nationally and internationally. Primary clarithromycin resistance and dual clarithromycin and metronidazole resistance are high in Ireland. These trends call for an evaluation of best-practice management strategies.

OBJECTIVE:

The objective of this study was to revise the recommendations for the management of H. pylori infection in adult patients in the Irish healthcare setting.

METHODS:

The Irish H. pylori working group (IHPWG) was established in 2016 and reconvened in 2023 to evaluate the most up-to-date literature on H. pylori diagnosis, eradication rates and antimicrobial resistance. The 'GRADE' approach was then used to rate the quality of available evidence and grade the resulting recommendations.

RESULTS:

The Irish H. pylori working group agreed on 14 consensus statements. Key recommendations include (1) routine antimicrobial susceptibility testing to guide therapy is no longer recommended other than for clarithromycin susceptibility testing for first-line treatment (statements 6 and 9), (2) clarithromycin triple therapy should only be prescribed as first-line therapy in cases where clarithromycin susceptibility has been confirmed (statement 9), (3) bismuth quadruple therapy (proton pump inhibitor, bismuth, metronidazole, tetracycline) is the recommended first-line therapy if clarithromycin resistance is unknown or confirmed (statement 10), (4) bismuth quadruple therapy with a proton pump inhibitor, levofloxacin and amoxicillin is the recommended second-line treatment (statement 11) and (5) rifabutin amoxicillin triple therapy is the recommend rescue therapy (statement 12).

CONCLUSION:

These recommendations are intended to provide the most relevant current best-practice guidelines for the management of H. pylori infection in adults in Ireland.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Helicobacter pylori / Infecciones por Helicobacter / Claritromicina / Quimioterapia Combinada / Inhibidores de la Bomba de Protones / Antibacterianos Límite: Adult / Humans País/Región como asunto: Europa Idioma: En Revista: Eur J Gastroenterol Hepatol Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Helicobacter pylori / Infecciones por Helicobacter / Claritromicina / Quimioterapia Combinada / Inhibidores de la Bomba de Protones / Antibacterianos Límite: Adult / Humans País/Región como asunto: Europa Idioma: En Revista: Eur J Gastroenterol Hepatol Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido