Current Trends in the Management of Helicobacter pylori Infection in Serbia: Preliminary Results from the European Registry on H. pylori Management.

Autor:	Milivojevic V; Clinic for Gastroenterology and Hepatology, University Clinical Centre of Serbia, Belgrade, Serbia.; Medical Faculty University of Belgrade, Belgrade, Serbia., Babic I; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Belgrade, Serbia., Kekic D; Medical Faculty University of Belgrade, Belgrade, Serbia.; Institute of Microbiology and Immunology, Belgrade, Serbia., Rankovic I; Clinic for Gastroenterology and Hepatology, University Clinical Centre of Serbia, Belgrade, Serbia.; Medical Faculty University of Belgrade, Belgrade, Serbia., Sagdati S; Regional Hospital Novi Pazar, Novi Pazar, Serbia., Panic N; Medical Faculty University of Belgrade, Belgrade, Serbia.; University Medical Centre Dr Dragiša Mišović, Belgrade, Serbia., Spasic IS; General Hospital Euromedic, Belgrade, Serbia., Krstic M; Clinic for Gastroenterology and Hepatology, University Clinical Centre of Serbia, Belgrade, Serbia.; Medical Faculty University of Belgrade, Belgrade, Serbia., Milosavljevic T; General Hospital Euromedic, Belgrade, Serbia., Moreira L; Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Clínic de Barcelona, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), University of Barcelona, Barcelona, Spain., Nyssen OP; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain., Mégraud F; INSERM U1312, Université de Bordeaux, Bordeaux, France., O' Morain C; Trinity College Dublin, Dublin, Ireland., Gisbert J; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Digestive diseases (Basel, Switzerland) [Dig Dis] 2023; Vol. 41 (3), pp. 377-386. Date of Electronic Publication: 2022 Dec 20.
DOI:	10.1159/000528389
Abstrakt:	Background: Helicobacter pylori (H. pylori) is the most common chronic bacterial infection. Treatment effectiveness remains a subject of debate considering bacterial antimicrobial resistance. Our aim was to analyze the diagnostic methods and eradication treatments for H. pylori infection in Serbia. Methods: An observational multicenter prospective study was conducted in Serbia, as part of the European Registry on H. pylori Management (Hp-EuReg). Demographics, treatment indication, diagnostic methods, previous eradication attempts, and treatment were collected at AEG-REDCap e-CRF. Modified intention-to-treat (mITT) and per-protocol (PP) effectiveness analyses were performed. Safety, compliance, and bacterial antimicrobial resistance rates were reported. Data were quality checked. Results: Overall, 283 patients were included, with a mean age of 55 ± 15 years. Dyspepsia (n = 214, 77%) was the most frequent treatment indication, and histology (n = 144, 51%) was the most used diagnostic method. Overall eradication rate was 95% (PP) and 94% (mITT). Most prevalent first-line therapy was quadruple PPI + clarithromycin + amoxicillin + metronidazole, with a 96% effectiveness (p < 0.001). Second-line main treatment choice was triple amoxicillin + levofloxacin, with a 95% effectiveness (p < 0.05). Single-capsule Pylera® was the most prescribed third-line therapy, with 100% effectiveness (p < 0.05). Longer treatment duration was associated with a higher eradication rate in first-line therapy (p < 0.05). Clarithromycin and quinolone resistance rates in first-line were 24% and 8.3%, respectively. The overall adverse events' incidence rate was 13.4%, and therapy compliance was 97%. Conclusions: Considering the high eradication rate, 14-day non-bismuth quadruple concomitant therapy is a reasonable first-line choice, while quinolone-based therapy and single-capsule Pylera® should be considered as rescue therapy options. (© 2023 S. Karger AG, Basel.)
Databáze:	MEDLINE
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