Most Read Articles
Rachel Soon, 2 days ago

Guidelines for local pharmacists on what actions to take during the COVID-19 pandemic have been issued by the Malaysian Pharmaceutical Society (MPS).

Elvira Manzano, 22 Nov 2017
A blood pressure (BP) reading of 130/80 mm Hg or higher is the ‘new high’ in the latest AHA/ACC* hypertension guidelines, a threshold that is tighter than the JNC 7** cutpoint of 140/90 mm Hg for stage 1 hypertension in the general population. The change will mean more patients being labelled with hypertension.
Roshini Claire Anthony, 17 hours ago

The reduction in bleeding events with 12-month ticagrelor monotherapy after 3-month dual antiplatelet therapy (DAPT) among high-risk patients who have undergone percutaneous coronary intervention (PCI) in the TWILIGHT* trial is consistent among patients with diabetes mellitus (DM), the TWILIGHT-DM trial showed.

02 Apr 2020
Cabozantinib plus androgen deprivation therapy (ADT) shows potent clinical activity in hormone-naïve metastatic prostate cancer (HNMPCa), according to the results of a phase II trial.

Nitroimidazole exposure may dampen efficacy of triple therapy in H. pylori infection

25 Mar 2020
Helicobacter pylori infection causes acute and chronic gastroduodenal inflammation in the upper gastrointestinal tract

Exposure to nitroimidazole appears to mitigate the efficacy of nitroimidazole-based triple regimen, but not quadruple therapy, in patients with Helicobacter pylori infection, results of a study have shown.

A nitroimidazole-containing regimen was given to 1,386 patients (aged 40.7±10.7 years; 34.8 percent males), including 282 (20.4 percent) with prior nitroimidazole exposure. Of the patients, 58.9 percent and 73.8 percent with and without prior nitroimidazole exposure, respectively, achieved successful eradication (odds ratio [OR], 0.51, 95 percent confidence interval [CI], 0.39–0.67; p<0.0001).

Interestingly, nitroimidazole exposure had an adverse effect on the success of triple therapy containing nitroimidazole, proton pump inhibitor, and amoxicillin or clarithromycin, but not quadruple therapy (39.4 percent vs 63.4 percent and 54.4 percent vs 73.6 percent, respectively; p<0.01).

Multivariable analysis revealed a significant association between nitroimidazole exposure and eradication failure (OR, 1.89, 95 percent CI, 1.43–2.50; p<0.0001). Patients with successful eradication had a greater time elapsed from nitroimidazole exposure and a lower cumulative nitroimidazole dose (pboth<0.0001).

“Clinicians should conduct a thorough patient drug history before administering empiric treatment for H. pylori infection,” the authors said.

The database of Clalit Health Services was accessed to identify individuals aged 25–60 years who underwent a first-ever 13C-urea breath test between 2010 and 2015. Those who underwent a previous H. pylori stool antigen test or gastroscopy were excluded from the analysis. Data on pharmacy dispensation were also retrieved.

“Prior nitroimidazole exposure may increase the likelihood of nitroimidazole-resistant H. pylori,“ the authors said. “Current H. pylori treatment guidelines recommend that, in the absence of susceptibility testing, patients with prior nitroimidazole exposure should not be treated with a nitroimidazole antibiotic.”

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Most Read Articles
Rachel Soon, 2 days ago

Guidelines for local pharmacists on what actions to take during the COVID-19 pandemic have been issued by the Malaysian Pharmaceutical Society (MPS).

Elvira Manzano, 22 Nov 2017
A blood pressure (BP) reading of 130/80 mm Hg or higher is the ‘new high’ in the latest AHA/ACC* hypertension guidelines, a threshold that is tighter than the JNC 7** cutpoint of 140/90 mm Hg for stage 1 hypertension in the general population. The change will mean more patients being labelled with hypertension.
Roshini Claire Anthony, 17 hours ago

The reduction in bleeding events with 12-month ticagrelor monotherapy after 3-month dual antiplatelet therapy (DAPT) among high-risk patients who have undergone percutaneous coronary intervention (PCI) in the TWILIGHT* trial is consistent among patients with diabetes mellitus (DM), the TWILIGHT-DM trial showed.

02 Apr 2020
Cabozantinib plus androgen deprivation therapy (ADT) shows potent clinical activity in hormone-naïve metastatic prostate cancer (HNMPCa), according to the results of a phase II trial.