BACKGROUND: Bismuth quadruple therapies (BQTs) including bismuth, a proton pump inhibitor (PPI) and two antibiotics have been shown to be highly effective for treating Helicobacter pylori infection even in areas of high bacterial antibiotic resistance. OBJECTIVE: To describe the time trends of use, effectiveness and safety of BQT in Europe using the European Registry on Helicobacter pylori Management (Hp-EuReg). DESIGN: Patients registered in the Hp-EuReg from 2013 to 2021 who had received BQT were included. The regimens prescribed, the number of eradication attempts, effectiveness, adherence and safety were analysed. The effectiveness was assessed by modified intention to treat (mITT). Time-trend and multivariate analyses were performed to determine variables that predicted treatment success. RESULTS: Of the 49 690 patients included in the Hp-EuReg, 15 582 (31%) had received BQT. BQT use increased from 8.6% of all treatments in 2013 to 39% in 2021. Single-capsule BQT-containing bismuth, metronidazole and tetracycline-plus a PPI (single-capsule BQT, ScBQT) was the most frequent treatment mode (43%). Schemes that obtained an effectiveness above 90% were the 10-day ScBQT and 14-day BQT using tetracycline plus metronidazole, or amoxicillin plus either clarithromycin or metronidazole. Only ScBQT achieved above 90% cure rates in all the geographical areas studied. Using the ScBQT scheme, adherence, the use of standard or high-dose PPIs, 14-day prescriptions and the use of BQT as first-line treatment were significantly associated with higher mITT effectiveness. CONCLUSION: The use of BQT increased notably in Europe over the study period. A 10-day ScBQT was the scheme that most consistently achieved optimal effectiveness. TRIAL REGISTRATION NUMBER: NCT02328131.

• Klíčová slova
• ANTIBIOTIC THERAPY, HELICOBACTER PYLORI - TREATMENT, HELICOBACTER THERAPY,
• MeSH
• amoxicilin terapeutické užití   aplikace a dávkování   MeSH
• antibakteriální látky * terapeutické užití   škodlivé účinky   aplikace a dávkování   MeSH
• bismut * terapeutické užití   aplikace a dávkování   MeSH
• dospělí MeSH
• Helicobacter pylori * účinky léků   MeSH
• infekce vyvolané Helicobacter pylori * farmakoterapie   MeSH
• inhibitory protonové pumpy * terapeutické užití   aplikace a dávkování   škodlivé účinky   MeSH
• klarithromycin terapeutické užití   aplikace a dávkování   MeSH
• kombinovaná farmakoterapie * MeSH
• lidé středního věku MeSH
• lidé MeSH
• metronidazol terapeutické užití   aplikace a dávkování   MeSH
• registrace * MeSH
• senioři MeSH
• tetracyklin terapeutické užití   aplikace a dávkování   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• amoxicilin MeSH
• antibakteriální látky * MeSH
• bismut * MeSH
• inhibitory protonové pumpy * MeSH
• klarithromycin MeSH
• metronidazol MeSH
• tetracyklin MeSH

BACKGROUND: The aim of this study was comparison the effectiveness of sequential and standard quadruple therapy on eradication of H. pylori infection. METHODS: This clinical trial study was conducted on 160 patients with dyspepsia or gastroduodenal ulcer. Patients were randomly divided into two groups. Group A (standard regimen) received omeprazole, amoxicillin, clarithromycin and bismuth subcitrate for 2 weeks. Group B (sequential regimen) received omeprazole and amoxicillin in 5 days and omeprazole, tinidazole and levofloxacin in 5 days. After the end of treatment regimens, 20 mg omeprazole was administered twice daily for 3 weeks. H. pylori eradication was assessed 2 months after antibiotic treatment via fecal antigen. RESULTS: Frequency of H. pylori eradication in group A and B was observed in 55 (68.8%) and 63 patients (78.8%), respectively. No significant difference was seen between two groups, regarding H. pylori eradication (p = 0.15). The most common side effects in group A, B were bitterness of mouth (63.8%) and nausea (16.2%), respectively (p H. pylori infection, higher rate of H. pylori eradication was seen in group B than group A. Thus, sequential regimen was a more appropriate regimen with fewer complications.

• Klíčová slova
• H. pylori infection, Sequential therapy, eradication, standard triple-drug therapy,
• MeSH
• amoxicilin aplikace a dávkování   MeSH
• dospělí MeSH
• Helicobacter pylori MeSH
• infekce vyvolané Helicobacter pylori farmakoterapie   MeSH
• klarithromycin aplikace a dávkování   MeSH
• kombinovaná farmakoterapie MeSH
• levofloxacin aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• omeprazol aplikace a dávkování   MeSH
• organokovové sloučeniny aplikace a dávkování   MeSH
• senioři MeSH
• tinidazol aplikace a dávkování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• srovnávací studie MeSH
• Názvy látek
• amoxicilin MeSH
• bismuth tripotassium dicitrate MeSH Prohlížeč
• klarithromycin MeSH
• levofloxacin MeSH
• omeprazol MeSH
• organokovové sloučeniny MeSH
• tinidazol MeSH

We report a case of cavitary pulmonary disease caused by Mycobacterium shimoidei in 67-year-old female with history of asthma. Even though susceptibility testing was not available, choice of treatment regimen (streptomycin, rifampicin, ethambutol, and clarithromycin), based on a few cases with favorable outcome reported in the literature, resulted with an excellent clinical, microbiological, and radiological response. This is the first report of pulmonary disease caused by M. shimoidei, but also the first ever isolation of M. shimoidei in Croatia.

• MeSH
• antibakteriální látky aplikace a dávkování   MeSH
• atypické mykobakteriální infekce farmakoterapie   mikrobiologie   MeSH
• klarithromycin aplikace a dávkování   MeSH
• lidé MeSH
• netuberkulózní mykobakterie účinky léků   izolace a purifikace   fyziologie   MeSH
• plicní nemoci farmakoterapie   mikrobiologie   MeSH
• rifampin aplikace a dávkování   MeSH
• senioři MeSH
• streptomycin aplikace a dávkování   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Geografické názvy
• Chorvatsko MeSH
• Názvy látek
• antibakteriální látky MeSH
• klarithromycin MeSH
• rifampin MeSH
• streptomycin MeSH

BACKGROUND AND AIM: Helicobacter pylori (H. pylori) infection is reported to be associated with various extragastrointestinal conditions such as insulin resistance, diabetes mellitus and metabolic syndrome. These conditions are attributed to systemic inflammation, leptin or ghrelin changes due to H. pylori infection. Therefore, increasing trends in the management of H. pylori infection are ordered to maintain glycemic control. In this study, we evaluated the effect of H. pylori eradication on insulin resistance in patients with normal blood glucose concentrations. METHOD: A total of 370 patients with successful eradication were included in the study. Patients with H. pylori were given triple eradication treatment. All patients with H. pylori infection were tested for fasting glucose, fasting insulin, glicated hemoglobin (HbA1c) at baseline and 6 months after eradication treatment. Also, insulin resistance was calculated using the homeostatic model assessment of insulin resistance (HOMA-IR). Body mass index was also determined as a metabolic syndrome criteria effecting insulin resistance. RESULTS: There were significant differences in fasting glucose, fasting insulin, HbA1c, and HOMA-IR values between before treatment and after treatment(P <0.04, <0.01, <0.01, <0.01). The favorable effect of eradication was more significant in patients with BMI≥25 mg/m(2)(P<0.05). CONCLUSION: Eradication treatment has beneficial effects on insulin resistance in patients with normal glucose concentrations.

• Klíčová slova
• Helicobacter pylori, body mass index, insulin resistance,
• MeSH
• amoxicilin aplikace a dávkování   MeSH
• antibakteriální látky aplikace a dávkování   MeSH
• dospělí MeSH
• glykovaný hemoglobin metabolismus   MeSH
• Helicobacter pylori * MeSH
• homeostáza MeSH
• infekce vyvolané Helicobacter pylori farmakoterapie   MeSH
• inzulinová rezistence fyziologie   MeSH
• jednoduchá slepá metoda MeSH
• klarithromycin aplikace a dávkování   MeSH
• kombinovaná farmakoterapie MeSH
• krevní glukóza metabolismus   MeSH
• lanzoprazol aplikace a dávkování   MeSH
• lidé MeSH
• prospektivní studie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky kontrolované MeSH
• Názvy látek
• amoxicilin MeSH
• antibakteriální látky MeSH
• glykovaný hemoglobin MeSH
• klarithromycin MeSH
• krevní glukóza MeSH
• lanzoprazol MeSH

AIMS: Cytokine levels in nasal secretions reflect the inflammatory status of the nasal and paranasal sinus mucosa and the development of mucosal disease. The results of previous investigations suggest that macrolide antibiotics can be effective in treatment of chronic rhinosinusitis and nasal polyposis. The aim of this prospective study was to compare the immunomodulatory and clinical effects of long-term low-dose macrolide treatment of nonatopic and atopic patients with nasal polyposis. METHODS: Forty (n = 40) patients with nasal polyposis, 22 allergic and 18 nonallergic were administered clarithromycin (CAM) 500 mg/day single oral dose for eight weeks. We measured the levels of proinflammatory Th1 cytokines TNF-α and IL-1β, Th2 cytokines IL-4, IL-5 and IL-6, and chemokine IL-8 in the nasal fluid samples, before and after treatment, using flow cytometric method. We also scored each of the 40 patients before and after therapy according to nasal symptom score and endoscopic score. RESULTS: Following treatment, we found significantly reduced levels of IL-8 (p<0.01) and TNF-α (p<0.01) in nasal secretions in nonallergic patients. In subjects with nasal polyposis and allergy, we found decreased levels of IL-8 (p<0.01), IL-6 (p<0.05) and IL-1β (p<0.01). Macrolide therapy decreased the size of polyps in 45.45% of nonatopic and in 50% of atopic patients. After macrolide treatment, we found 67.83% patients in nonallergic group and 55.55% patients in allergic group with improved nasal symptoms. CONCLUSIONS: Long-term low-dose treatment with CAM was effective in the management of nasal polyposis. Our results showed that macrolide treatment of nasal polyposis have different immunomodulatory and similar clinical effects in allergic and nonallergic patients.

• MeSH
• alergie komplikace   MeSH
• dospělí MeSH
• imunologické faktory aplikace a dávkování   MeSH
• klarithromycin aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• nosní polypy komplikace   farmakoterapie   MeSH
• prospektivní studie MeSH
• rozvrh dávkování léků MeSH
• senioři MeSH
• výsledek terapie MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• imunologické faktory MeSH
• klarithromycin MeSH

A significant increase in H. pylori resistance to clarithromycin and metronidazole has been proven in both children and adults. Clarithromycin with resistance over 20 % and metronidazole with resistance over 40 % are not recommended for treating H. pylori infection. Preferred treatment regimens were designed to reflect the current situation. The classical regimen PPI + AMO + CLA (MET) can be used in cases where the resistance against CLA and MET is lower than stated above. In the opposite case, a combination of PPI + AMO + levofloxacin (or rifabutin, or furazolidone) must be used. In many countries, this regimen is already the first-choice treatment. The 4-combination with bismuth is suitable in case of 3-combination treatment failure, or in patients allergic to penicillin.

• MeSH
• antibakteriální látky aplikace a dávkování   MeSH
• bakteriální léková rezistence MeSH
• Helicobacter pylori účinky léků   MeSH
• infekce vyvolané Helicobacter pylori farmakoterapie   mikrobiologie   MeSH
• inhibitory protonové pumpy terapeutické užití   MeSH
• klarithromycin aplikace a dávkování   MeSH
• kombinovaná farmakoterapie MeSH
• levofloxacin MeSH
• lidé MeSH
• metronidazol aplikace a dávkování   MeSH
• ofloxacin aplikace a dávkování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antibakteriální látky MeSH
• inhibitory protonové pumpy MeSH
• klarithromycin MeSH
• levofloxacin MeSH
• metronidazol MeSH
• ofloxacin MeSH

Effective eradication regimes of Helicobacter pylori infections are nowadays based on administration of a substance with a strong suppressive effect on production of gastric HCl combined with two antibiotics. As suppressor of gastric HCl production unequivocally some drug from the group of proton pump blockers is used. As to antibiotics, in first line therapy the following are recommended: clarithromycin, amoxicillin, metronidazole. A problem in the eradication therapy of Helicobacter pylori infection in recent years is the increasing resistance to clarithromycin and apparently also metronidazole. In the Czech Republic the resistance to clarithromycin in relation to Helicobacter pylori is stabilized at a level lower than 3.0 %. Resistance to metronidazole was reported in 1992 within the range of 24 % - 26 %, however in 2001 it was already 36.0 %. Therefore the question arises whether it is possible under our conditions to check the increasing metronidazole resistance by a drug which by its spectrum of action resembles metronidazole while it differs from it as to its chemical structure. This is the reason why the authors implemented a trial where metronidazole was replaced by tinodazole (Avrazor, Léciva Co.). The results revealed that in the group treated with tinidazole eradication was achieved after 7-day administration of ornidazole in 93.0 %, in the group where part of the eradication regime was metronidazole eradication was 82.6 %. The tolerance of both drugs was very good. The authors recommend to include the pattern omeprazole 2 x 20 mg, clarithromycin 2 x 500 mg and tinidazole 2 x 500 mg among first line therapeutic regimes.

• MeSH
• antibakteriální látky aplikace a dávkování   MeSH
• bakteriální léková rezistence MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• Helicobacter pylori * účinky léků   MeSH
• infekce vyvolané Helicobacter pylori farmakoterapie   mikrobiologie   MeSH
• inhibitory protonové pumpy MeSH
• klarithromycin aplikace a dávkování   MeSH
• kombinovaná farmakoterapie MeSH
• lidé středního věku MeSH
• lidé MeSH
• metronidazol aplikace a dávkování   MeSH
• mladiství MeSH
• omeprazol aplikace a dávkování   MeSH
• ornidazol aplikace a dávkování   MeSH
• peptický vřed farmakoterapie   mikrobiologie   MeSH
• protivředové látky aplikace a dávkování   MeSH
• rozvrh dávkování léků MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH
• Názvy látek
• antibakteriální látky MeSH
• inhibitory protonové pumpy MeSH
• klarithromycin MeSH
• metronidazol MeSH
• omeprazol MeSH
• ornidazol MeSH
• protivředové látky MeSH

In this study, in vivo effectiveness of ascorbic acid (AA), beta carotene (BC) and allicin in HP eradication were evaluated. 210 patients who are HP positive in biopsy were involved in this study. The patients randomised to seven treatment groups (each group consisting of 30 patients). The first group was given standard eradication treatment (lansaprasol 30 mg bid, clarithromycin 500 mg bid, amoxicillin 1 g bid for 14 days). Second group received AA 1000 mg/day in addition to the standard treatment. Third group received only AA 1000 mg/day for 14 days. Fourth group was treated with standard regiment plus 120 mg/day BC. Fifth group was given only BC 120 mg/day for 14 days. Sixth group was given standard regiment and allicin 4200 micrograms/day. Seventh group received only Allicin 1200 micrograms/day for 14 days. The eradication was achieved in 20 (66.6%) in group I, 15 (50%) in group II, 3 (10%) in group III, 15 (50%) in group IV, 0 (0%) in group V, 27 (90%) in group VI and 7 (23.3%) in group VII. Allicin seemed to be potentially effective agent for HP eradication but ascorbic acid, beta caroten was found to be ineffective.

• MeSH
• 2-pyridinyl methylsulfinyl benzimidazoly MeSH
• amoxicilin aplikace a dávkování   MeSH
• antibakteriální látky aplikace a dávkování   terapeutické užití   MeSH
• antioxidancia terapeutické užití   MeSH
• beta-karoten terapeutické užití   MeSH
• disulfidy MeSH
• dospělí MeSH
• gastritida farmakoterapie   mikrobiologie   MeSH
• Helicobacter pylori * účinky léků   izolace a purifikace   MeSH
• infekce vyvolané Helicobacter pylori farmakoterapie   mikrobiologie   MeSH
• klarithromycin aplikace a dávkování   MeSH
• kombinovaná farmakoterapie MeSH
• kyselina askorbová terapeutické užití   MeSH
• kyseliny sulfinové terapeutické užití   MeSH
• lanzoprazol MeSH
• lidé MeSH
• omeprazol aplikace a dávkování   analogy a deriváty   MeSH
• protivředové látky aplikace a dávkování   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• 2-pyridinyl methylsulfinyl benzimidazoly MeSH
• allicin MeSH Prohlížeč
• amoxicilin MeSH
• antibakteriální látky MeSH
• antioxidancia MeSH
• beta-karoten MeSH
• disulfidy MeSH
• klarithromycin MeSH
• kyselina askorbová MeSH
• kyseliny sulfinové MeSH
• lanzoprazol MeSH
• omeprazol MeSH
• protivředové látky MeSH

BACKGROUND/AIMS: The eradication of Helicobacter pylori (Hp) infection in duodenal ulcer and dyspepsia has been achieved using various therapy regimens. The efficacy of protein pump inhibitor pantoprazole as part of these regimens has not been widely studied. METHODOLOGY: During a prospective randomized trial, 250 Hp positive patients with either duodenal ulcer, erosive bulbitis, or gastritis and dyspepsia were treated using 14 days of therapy 1) pantoprazole 40 mg daily and clarithromycin 500 mg b.i.d. (PC), 2) pantoprazole 40 mg daily and clarithromycin 500 mg b.i.d. plus amoxicillin 1 g b.i.d. (PCA), or 3) bismuth subcitrate 120 mg t.i.d., roxithromycin 150 mg b.i.d., metronidazole 250 mg b.i.d. plus ranitidin 300 mg (BRMR). Hp status was assessed on 3 tests at the inclusion (2-specimen rapid urease test, 2-specimen histology, serology) and 2 tests (2-specimen rapid urease test, 2-specimen histology) 4 weeks after the end of the treatment. RESULTS: The entry criteria was fulfilled in 250 patients, of whom 13 missed the control endoscopy. The treatment had to be discontinued for adverse effects in 8 (10%) BRMR patients, and 1 (1%) PCA patients. Compliance was 100% in the PC group. All ulcers were healed at the end of the study with one exception in the BRMR group. The best eradication rate of Hp was shown by the PCA group with 94.8% (n = 73/77) followed by the PC group with 82.5% (n = 66/80) and finally the BRMR with 67.6% (n = 48/71)-PCA:BRMR - p < 0.001; PC:BRMR-p < 0.001; PCA:PC-p < 0.05. CONCLUSION: This study showed that triple therapy using PPI pantoprazole combined with antibiotics clarithromycin and amoxicillin was very effective in the eradication of Hp and treatment of duodenal ulcer with rare side effects. The dual pantoprazole and clarithromycin therapy had the highest rate of patient compliance, but is less effective than triple therapy. The combination of ranitidin with bismuth based triple therapy had the highest number of adverse events and the lowest rate of Hp eradication and therefore, should not be recommended.

• MeSH
• 2-pyridinyl methylsulfinyl benzimidazoly MeSH
• amoxicilin aplikace a dávkování   MeSH
• benzimidazoly aplikace a dávkování   MeSH
• dospělí MeSH
• dvanáctníkové vředy farmakoterapie   mikrobiologie   MeSH
• dyspepsie farmakoterapie   mikrobiologie   MeSH
• gastritida farmakoterapie   mikrobiologie   MeSH
• Helicobacter pylori * izolace a purifikace   MeSH
• infekce vyvolané Helicobacter pylori farmakoterapie   mikrobiologie   MeSH
• klarithromycin aplikace a dávkování   MeSH
• kombinovaná farmakoterapie terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metronidazol aplikace a dávkování   MeSH
• mladiství MeSH
• nemoci žaludku farmakoterapie   mikrobiologie   MeSH
• omeprazol analogy a deriváty   MeSH
• organokovové sloučeniny aplikace a dávkování   MeSH
• pantoprazol MeSH
• prospektivní studie MeSH
• protivředové látky aplikace a dávkování   MeSH
• ranitidin aplikace a dávkování   MeSH
• roxithromycin aplikace a dávkování   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sulfoxidy aplikace a dávkování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• 2-pyridinyl methylsulfinyl benzimidazoly MeSH
• amoxicilin MeSH
• benzimidazoly MeSH
• bismuth tripotassium dicitrate MeSH Prohlížeč
• klarithromycin MeSH
• metronidazol MeSH
• omeprazol MeSH
• organokovové sloučeniny MeSH
• pantoprazol MeSH
• protivředové látky MeSH
• ranitidin MeSH
• roxithromycin MeSH
• sulfoxidy MeSH