Most Read Articles
20 May 2019

Dr Michael Lim, a senior consultant at the Paediatric Pulmonary and Sleep Division, National University Hospital, Singapore, speaks to Roshini Claire Anthony on the rare disease that is cystic fibrosis.

31 May 2019
Co-therapy with proton pump inhibitors (PPIs) in patients receiving low-dose anticoagulation and/or aspirin for stable cardiovascular disease confers no benefit for upper gastrointestinal events but may reduce bleeding due to gastroduodenal lesions, a study has shown.
07 May 2019
Adding bismuth to a 14-day course of standard triple therapy with clarithromycin and amoxicillin leads to a high rate of Helicobacter pylori infection eradication, with an acceptable safety profile and level of adherence, according to a study.
Laura Kho Sui San , 29 May 2019
Anxiety becomes a pathological disorder when it occurs for no detectable reason, persists and interferes with daily activities like work performance and relationships.

Susceptibility-guided and empiric therapy equally effective in H. pylori infection

22 May 2019

Susceptibility‐guided therapy is as effective as empiric modified bismuth quadruple therapy for the first-line treatment of Helicobacter pylori infection, with both yielding excellent eradication rates, as shown in a recent trial.

Researchers conducted a multicentre superiority‐design trial, which randomly assigned 382 patients with H. pylori infection to (a) susceptibility‐guided therapies containing esomeprazole 20 mg and amoxicillin 1 g twice daily plus clarithromycin 500 mg, metronidazole 400 mg twice daily, or levofloxacin 500 mg daily for susceptible infections or bismuth 220 mg twice daily and metronidazole 400 mg four times daily for triple‐resistant infections; or to (b) empiric therapy containing esomeprazole 20 mg, bismuth 220 mg twice daily, amoxicillin 1 g and metronidazole 400 mg thrice daily.

Rates of H. pylori eradication were high and similar in the susceptibility‐guided and the empiric regimens (per-protocol rates: 97.7 percent vs 97.6 percent; p=1.00; intent‐to‐treat rates: 91.6 percent vs 85.4 percent; p=0.12).

Overall, susceptibility‐guided therapy was not superior to empiric therapy, with a difference of 0.1 percent in per‐protocol rate and 6.2 percent in intent‐to‐treat rate. Furthermore, both treatment approaches had high adherence and were associated with low adverse event rates.

In light of the findings, researchers pointed out that choosing between the two approaches would depend on availability of susceptibility testing and/or a locally highly effective empiric therapy.

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Most Read Articles
20 May 2019

Dr Michael Lim, a senior consultant at the Paediatric Pulmonary and Sleep Division, National University Hospital, Singapore, speaks to Roshini Claire Anthony on the rare disease that is cystic fibrosis.

31 May 2019
Co-therapy with proton pump inhibitors (PPIs) in patients receiving low-dose anticoagulation and/or aspirin for stable cardiovascular disease confers no benefit for upper gastrointestinal events but may reduce bleeding due to gastroduodenal lesions, a study has shown.
07 May 2019
Adding bismuth to a 14-day course of standard triple therapy with clarithromycin and amoxicillin leads to a high rate of Helicobacter pylori infection eradication, with an acceptable safety profile and level of adherence, according to a study.
Laura Kho Sui San , 29 May 2019
Anxiety becomes a pathological disorder when it occurs for no detectable reason, persists and interferes with daily activities like work performance and relationships.