جستجوی مقالات مرتبط با کلیدواژه « eradication » در نشریات گروه « پزشکی »

Helicobacter pylori (H. pylori) has infected about 50% of the world’s population and it is the main cause for peptic ulcer, gastric adenocarcinoma and even a major cause for gastric MALT lymphoma.

This study was performed in Mazandaran, Sari, situated in North of Iran. Three-hundred and twenty-eight adult patients with endoscopically approved gastric or duodenal ulcers or erosions and H. pylori infection were randomly divided into 2 groups to receive either 14 days PABT (Pantoprazole 40 mg, Amoxicillin 1 g, Bismuth 425 mg (all twice daily) and Tetracycline 500 mg four times a day) and PACM (Pantoprazole 40 mg, Amoxicillin 1g, Clarithromycin 500 mg, and Metronidazole 500 mg, all twice daily). To evaluate H. pylori eradication, fecal H. pylori antigen test was performed 8 weeks after treatment.

The eradication rates were 94.51% in the PATB and 91.46% in PACM group based on the intention to treat analysis. Moreover, the eradication rates were 95.58% and 92.72% according to per-protocol analysis, respectively. Also, both groups had very low rates of severe side effects.

Regarding the ideal eradication rates achieved by both treatment groups and the low rates of severe side effects, both treatment protocols can be prescribed for H. pylori eradication in North of Iran.

The ideal combination regimen for Helicobacter pylori (HP) eradication has not yet been determined and the success rate of HP eradication has been extensively reduced worldwide due to increasing antibiotic resistance. So this multinational multi-center randomized controlled trial was designed to evaluate the efficacy of tetracycline +levofloxacin for HP eradication.

During a 6-month period, all of the cases with HP infection in eight referral tertiary centers of three countries were included and randomly allocated to receive either tetracycline + levofloxacin or clarithromycin plus amoxicillin quadruple regimen for two weeks. For all of the participants, pantoprazole was continued for 4 more weeks and after one to two weeks of off-therapy, they underwent urea breath test C13 to prove eradication.

Overall 788 patients were included (358 male (45.4%), average age 44.2 years). They were diagnosed as having non-ulcer dyspepsia (516 cases, 65.5%), peptic ulcer disease (PUD) (234 cases, 29.69%), and intestinal metaplasia (38 cases, 4.8%). Racially 63.1% were Caucasian, 14.5% Arab, 15.6% African, and 6.1% Asian. The participants were randomly allocated to groups A and B to receive either tetracycline + levofloxacin or clarithromycin. Among groups A and B in intention to treat (ITT) and per protocol (PP) analysis, 75.2% & 82.1% (285 cases) and 67.5% & 70.1% (276 cases) of participants achieved eradication, respectively (P = 0.0001). The complete compliance rate in groups A and B were 84.4% and 83.6%, respectively. During the study, 33.5% of the participants in group A (127 cases) reported side effects while the complication rate among group B was 27.9% (114 cases, P = 0.041). The most common complaints among groups A and B were nausea and vomiting (12.6% & 9.3%) and abdominal pain (4.48% & 2.68%), respectively. The rate of severe complications that caused discontinuation of medication in groups A and B were 2.1% and 1.46%, respectively (P = 679). In subgroup analysis, the eradication rates of tetracycline+levofloxacin among patients with non-ulcer dyspepsia, PUD, and intestinal metaplasia were 79.4%, 88.1%, and 73.9%, respectively. These figures in group B (clarithromycin base) were 71.3%, 67.6%, and 61.5% respectively (P = 0.0001, 0.0001, and 0.043).

Overall, the combination of tetracycline+levofloxacin is more efficient for HP eradication in comparison with clarithromycin+amoxicillin despite more complication rate. In areas with a high rate of resistance to clarithromycin, this therapeutic regimen could be an ideal choice for HP eradication, especially among those who were diagnosed with PUD.

The increasing prevalence of antibiotic-resistant strains of Helicobacter pylori (H. pylori) led to reduced success with traditional H. pylori treatments. This warrants further evaluation of other treatment options. One such treatment regimen of interest is nitazoxanide containing regimen. In this study, we evaluated the efficacy of the addition of nitazoxanide to clarithromycin-based triple therapy in patients with H. pylori infection.

In this single-center prospective observational trial, patients with H. pylori infection were treated with a regimen comprising of nitazoxanide 1000 mg, amoxicillin 2000 mg, clarithromycin 1000 mg, and esomeprazole 80 mg per day (NACE regimen) for14 days. Eradication of H. pylori infection was assessed 4 weeks after completion of therapy by using stool antigen assay. Treatment compliance and adverse effects were also evaluated.

Out of 111 patients who entered into the study for final analysis, H. pylori eradication was achieved in 93.7% (104 out of 111) patients in per-protocol analysis and 90.4% (104 out of 115) patients in intention to treat analysis. The treatment regimen was well tolerated.

The addition of nitazoxanide to standard clarithromycin-based triple therapy effectively eradicates H. pylori infection. This regimen is safe and well tolerated.

Helicobacter pylori (H.pylori) is the main known cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. Eradication of H.pylori can be an effective method of treatment for peptic ulcer disease and mucosa‐associated lymphoid tissue lymphoma. This study aimed to compare the effectiveness of levofloxacin versus clarithromycin in the eradication of H.pylori. This randomized clinical trial was conducted on 170 cases with H.pylori infection in Kerman. The participants were randomly allocated to two groups. As the first line therapy, ‘A’ group was treated twice a day with clarithromycin (500mg), pantoprazole (40mg) and amoxicillin (1gr) for 14 days and ‘B’ group was treated twice a day with levofloxacin (250mg), pantoprazole (40mg) and amoxicillin (1gr) for 14 days. Stool H.pylori antigen test was performed one month after the end of treatment. To analyze the data, descriptive and analytical methods and SPSS software version 22 were used. The study cases were comprised of 170 individuals (52.35%female). The mean age of patients in ‘A’ and ‘B’ groups was 42±11.88 and 41±13.75 years, respectively. H.pylori eradication was successful in 61.1% of ‘A’ group and 92.9% of ‘B’ group showing a significant difference (P=0.037). Drug complications were reported in 7.1% of ‘A’ group and 4.7% of ‘B’ group which showed no significant difference between the two groups (P=0.772). The most common drug complication in both groups was abdominal pain (2.3%). The results of this study indicated that levofloxacin-containing regimen was more effective in eradicating H.pylori than the standard clarithromycin triple therapy.

Helicobacter pylorus is a widespread infection in India. Resistance to commonly used antibiotics against Helicobacter pylori increases rapidly, leading to traditional triple therapy's lower success. So, a search for a new regimen is needed. In this study, we compared the efficacy of 14-day triple therapy with a novel ten-day LOAD regimen to eradicate Helicobacter pylori infection in India .

In this randomized trial, patients with Helicobacter pylori infection were randomized to LOAD therapy (levofloxacin 250 mg OD, omeprazole 40 mg BD, nitazoxanide 500mg BD, and doxycycline 100 mg OD) for ten days and standard triple therapy ( pantoprazole 80 mg, amoxicillin 2000 mg, and clarithromycin 1000 mg daily in divided doses for 14 days ). Gastric biopsy/RUT was done 10–12 weeks after completing therapy to confirm Helicobacter pylori eradication.

The eradication rates with LOAD regimen were significantly greater than with standard triple therapy on both intention-to-treat analysis (82.75 % vs. 60.26 %, p = 0.001; difference, 22.49 % [95 % CI, 8.5-18 %] and per-protocol analysis (83.3 % vs. 62.75 %, p = 0.002; difference, 20.55 % [95 % CI, 7.1-22.5 %]). Both the treatment regimens were well tolerated.

Although the rate of eradication of H. pylori infection with the LOAD regimen was significantly higher than that with triple therapy, the efficacy was still suboptimal. It may be due to fluoroquinolone resistance or a short course of treatment.

The prevalence of Helicobacter pylori (H. pylori) in developing countries is 50.8%, with the highest occurrence presented in Africa (79.1%). It increases the risk of chronic gastritis, peptic ulcer, cancer of the stomach, and lymphoma. The effect of standard
treatment for H. pylori eradication is below 80%, and evaluation of alternative lines of treatment is needed. We aimed to compare the hybrid, reverse hybrid, and levofloxacin quadruple therapies as first-line therapy in Egypt.

This was a randomized interventional trial done in the clinics affiliated with the Internal Medicine Department. 330 individuals were selected according to the inclusion criteria. They were divided into three groups: group 1 (110 subjects who received a reverse hybrid regimen), group 2 (110 subjects who received a hybrid regimen), and group 3 (110 subjects who received a non-bismuth levofloxacin quadruple regimen).

Group 3 had a significantly lower eradication rate of 82.7% versus 92.7% and 91.8% in groups 1 and 2, respectively. There were non-significant differences in the incidence rates of adverse events among the three groups.

Both the reverse hybrid and hybrid groups had good eradication rates in the Egyptian population, but non-bismuth levofloxacin quadruple therapy did not obtain a sufficient eradication rate.

There are a variety of treatment regimens containing several antimicrobial compounds to treat Helicobacter pylori infection.

The aim of this study was to eradicate H. pylori infection in patients with gastrointestinal problems after the administration of a four-drug regimen.

This study was performedamong100 patients with gastrointestinal problems visitingImamKhomeini Hospital in Urmia, Iran. The data were collected using a checklist that included patient information and analyzed by chi-square and t-test.

Out of the 100 patients visiting the clinic, 60 (60%) were male, and the rest were women. Also, 67% of the patients had pain type dyspepsia, and 33% of them postprandial distress type. In pathologic study, 38% of the patients had H. pylori infection, with a significantly higher incidence in patients with pain type dyspepsia.

The results showed a relationship between the type of indigestion and the improvement of symptoms after receiving a four-drug regimen, indicating the need for proper planning to diagnose and treat the type of indigestion.

For several generations, people from some parts of Ghana have suffered in the hands of a yard-long "spaghetti-thin" worm, known as Dracunculus medinensis, which infects humans and leads to a disease known as Dracunculiasis, literally meaning "afflictions with little dragons." The disease, also commonly known as Guinea Worm Disease, Dracuntiasis, or Dracunculosis, is a 3000-year-old known parasitic infection that rarely made headlines before the mid-1980s. Guinea Worm Disease, a plague so ancient that it is believed to be the "fiery serpent torturing the Israelites in the desert," as described in the Old Testament. This paper reviews local and global efforts and strategies at eradicating the disease in Ghana and further diagnoses the problems that hindered the early realization of the desired results of these strategies. This article did not evaluate Ghanachr('39')s performance in the program. It is equally arduous to unearth all the reasons contributing to the somewhat uneasy road to eradication over three decades of efforts. This review analyzes time-trends, program documents, technical and non-technical reports, and research documents that reveal that Ghanachr('39')s program ended a decade of disappointing stagnation following the disruptive ethnic conflicts in the early 1990s in its most disease-endemic areas. Despite substantial reductions in the number of guinea worm cases during the mid-1980s, efforts to break the transmission chain in Ghana remained a daunting task. The efforts required continued international and political commitment, active surveillance, strengthening of interventions, and honesty of documenters at all levels.

This study aimed to analyze the cost-effectiveness of two routine therapeutic methods for H. pylori eradication in Iran

Because of the importance of Helicobacter pylori (H. pylori) eradication on gastric cancer prevalence and costs, an economic analysis of the eradication methods is essential for health systems.

This cross-sectional study was conducted on 7,496 participants with positive Hepadnaviridae (HPsAg) test results for H. pylori; 6,163 of them were treated with furazolidone (group A), and 1,333 participants were treated with clarithromycin (group B). Data on GP visits, medications, and HPsAg costs as direct costs and absence from work and transportation as indirect costs was collected by researcher-made questionnaire. Indirect costs were calculated based on face-to-face interviews with 365 patients of the Persian Cohort Center. Successful eradication of H. pylori infection (negative HPsAg) was defined as the effectiveness of the interventions. Incremental cost-effectiveness ratio (ICER) was used to compare the overall results.

The total direct cost of H. pylori for groups A and B were estimated at 13.7 and 5.83 billion IRR, respectively. The highest and lowest percentages of total costs were the cost of diagnostic services and the time cost, respectively. There was a significant difference between the two groups in drug costs (p<0.001). The effect ratio for groups A and B was 85.93% and 96.54%, respectively. Cost per effectiveness was higher for clarithromycin (CE=3,250,170 IRR) than for furazolidone (CE=2,988,488 IRR), and ICER showed that 5.1 Million IRR per participant is needed to eradicate H. pylori.

Based on the results, furazolidone was more cost-effective than clarithromycin for H. pylori treatment. Therefore, due to the high prevalence of H. pylori and the economic conditions of the health system in Iran, furazolidone can be a cost-effective choice between the two conventional treatment methods considering the results of further research and possible side effects.

Helicobacter pylori (H. pylori) is located in the digestive tract. This bacterium has a tendency to attack the stomach surface layer, mucosal changing, and eventually may involve in developing gastric cancer. In this regard, the main remaining issue is antibiotic resistance, which influences the efficacy of eradication regimens.

To assess the efficacy of two frequent anti-H. Pylori quadruple treatments consisting of omeprazole, bismuth, amoxicillin, and clarithromycin (OBAC) or tetracycline (OBMT).

Patients infected with H. pylori were assigned to receive omeprazole 20 mg, bismuth subcitrate 240 mg, metronidazole 500 mg, and tetracycline 500 mg twice a day versus omeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1000 mg, and bismuth subcitrate 240 mg twice a day. Non-inferiority analyses were conducted according to both intention-to-treat and per-protocol principles.

100 patients in each group were enrolled. The intention-to-treat eradication rate was 82% (82/100) in the group receiving OBMT and 85% (85/100) in the OBAC group. Per protocol, eradication rates were 88.1% (82/93) for the group receiving OBMT and 89.4% (85/95) for patients in the OBAC group. When considering non-inferiority analysis, there were no differences between the two groups in both methods of analysis.

The eradication rate of OBMT is not inferior to OABC, and both are effective in eradicating H. pylori in areas with high metronidazole resistance. OBMT is a good alternative against the increasing resistance to clarithromycin.

 Helicobacter pylori infection is the most common infection of human. This organism is responsible for the majority of peptic ulcer diseases, MALToma and gastric cancer, worldwide. Several regimen therapies against H. pylori had developed and are prescribed empirically, but therapies have rarely been optimized.

 In this study, we compared two regimens that are widely used in Iran, triple regimen (clarithromycin, amoxicillin, and omeprazole) and furazolidone-based quadruple regimen (furazolidone, amoxicillin, bismuth, and omeprazole) in some dyspeptic patients.

 In this cross-sectional study, 373 consecutive dyspeptic patients that H. pylori infection was established, randomized into one of the following groups; 188 in group A (treated with clarithromycin 500 mg, amoxicillin 1,000 mg, and omeprazole 20 mg twice daily for 10 days) and 185 in group B (furazolidone 200 mg, amoxicillin 1000 mg, bismuth subcitrate 240 mg and omeprazole 20 mg twice daily for 14 days). One month after discontinuation of the treatment, H. pylori eradication was evaluated with UBT.

 Mean age of the patients was 35.9 ± 12.3 years, and the male to female ratio was 1: 1.6. In the per-protocol analysis, the eradication rate of H. pylori was 63.7% in comparison to 93% in group A and B, respectively (P < 0.004).

 Our study showed furazolidone-based quadruple regimen is superior to the standard triple regimen; thus, it is recommended as the first choice.

To investigate the possibility that the eradication of H pylori infection is associated with a reduction in the risk of glaucoma.

Sixty-five successive patients with elevated intraocular pressure (IOP) or glaucoma were included in the study. Serum samples from all subjects were analyzed for the presence of H pylori- antibodies using ELISA. Forty patients with positive serologic test were included. Half of the patients enrolled into intervention group and the other half registered as control. Intervention arm was referred to the Gastroenterology Clinic for eradication of H pylori and evaluated for the effect of H pylori regimen eradication on IOP and glaucoma over 2 months of follow-up. The age-matched controls did not receive treatment. Urea breath test was applied to confirm eradication.

There was a significant (p=0.005) reduction in IOP after complete eradication in the intervention group.  This value was not significant in control patients (p=0.08). The mean IOP before treatment of glaucoma in the control group was 23.60±2.37 mmHg and after treatment with anti-glaucoma drugs was 14.25±1.48 mmHg on the onset of study, and 13.55±2.01 mmHg after follow up. The mean IOP before treatment of glaucoma in the intervention group was 24.55±3.6 mmHg and after treatment with anti-glaucoma drugs was 15.15±1.8 mmHg, and 14.3±1.6 mmHg after the eradication of H pylori with a drug regimen. However, after the treatment of glaucoma in all patients, the overall comparison of mean IOP differences showed no statistical difference (P=0.65).

H pylori eradication therapy may have a positive effect on the management of glaucoma.

Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections worldwide, which is associated with peptic ulcer disease and gastric cancer. In this study, we compared the efficacy of 10-day versus 12-day concomitant therapy as the first-line treatment for H. pylori eradication in Iran.

218 patients with peptic ulcer disease and naïve H. pylori infection, were randomly divided into two groups to receive either 10-day or 12-day concomitant regimens, composed of pantoprazole 40 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and metronidazole 500 mg, all given twice daily. Eight weeks after treatment, H. pylori eradication was assessed by 14C- urea breath test. The trial was registered in the Iranian Registry of Clinical Trials (code: IRCT20170521034070N2).

212 patients completed the study. According to the intention to treat analysis, the eradication rates were 83.6% (95% CI: 76.6-90.5) and 88.8% (95% CI: 82.8-94.7) in 10-day and 12-day concomitant therapy groups, respectively (p =0.24). Per-protocol eradication rates were 85.9% (95% CI: 79.3–92.4) and 92.6% (95% CI: 87.6–97.5), respectively (p =0.19). The rates of severe side effects were not statistically different between the two groups (3.6% vs. 8.1%; p=0.428).

12-day concomitant therapy could achieve ideal eradication rates by both intention to treat and per-protocol analyses. In order to reduce the cost of drugs and the rate of adverse effects of therapy, among 10-day and 12day regimens, 12-day concomitant therapy seems to be a good alternative to 14-day concomitant therapy that has been suggested by international guidelines

The studies have been equivocal about the association of Helicobacter pylori infection with chronic urticaria (CU) given some controversial evidence in recovery of urticaria following H. pylori eradication.

In this clinical trial, 120 patients between the ages of 4 and 20 with intractable CU were recruited. They were grouped into two categories based on urea breath test (UBT) result. UBT positive group received treatment and UBT was repeated after two months while being evaluated for clinical course over a six-month period. On the other hand, UBT negative group received standard treatment for urticaria.

All participants with CU have been studied as 40 cases of UBT positive and 80 cases of control group with negative UBT, consisted of 42 (35%) male and 78 (65%) female. Patients had suffered from urticaria on average 29.9 (±26.6) months prior to diagnosis. Statistically significant difference was noted between two groups, in terms of severity of urticaria, frequency of episodes, abdominal pain and duration of being symptomatic prior to diagnosis. After receiving treatment for H. pylori infection, among case group, 27(67.5%) of individuals achieved complete recovery of urticaria and 13 (32.5%) cases demonstrated partial resolution of urticaria, meanwhile 59 cases (73.8%) of control group became completely symptom-free, while 21 (26.3%) of the remaining individuals were in incomplete recovery. In comparison of response to treatment between the above-mentioned groups, there was not any statistically significant difference (P=0.47)

Our findings reveal that H. pylori infection might contribute to developing CU which highlights the significance of H. pylori eradication as an approach for CU.

Tuberculosis (TB) is a major public health challenge, especially in resource-limited settings. The burden of the disease is particularly larger in developing countries due to factors like poverty, undernutrition, and even HIV, which propagate its spread and complicates its control. West Africa, with its high levels of poverty, hunger, overcrowding, and infectious diseases like HIV, is not left out in the tuberculosis epidemic. Our study aimed to review the burden of TB and the challenges hindering its eradication in West Africa.

This review assesses available evidence on issues relating to the burden of tuberculosis and the challenges facing its eradication in West Africa. Search for relevant medical literature in biomedical databases such as PubMed, Google Scholars, and OVID was conducted with the appropriate key terms without date restriction. Fifty-seven articles were found in a search through the database; 33 data sources, including reports, were selected and reviewed in order to contribute data to this study.

From the study, the incidence of tuberculosis is high in West Africa, especially considering the high rate of factors, which propagate its spread. TB/HIV co-infection is also an issue in this region, as evidenced by the high burdens in Nigeria, Ghana, Liberia, and Guinea Bissau. In fact, Nigeria still holds the position of the country with the highest TB burden in West Africa and also account for about 4% of the TB incidence globally. However, the burden only represents an estimate due to paucity of data attributed to ineffective surveillance method. The rate at which the incidence of tuberculosis is declining is slow due to various challenges facing its eradication such as poverty, endemic of the causative agents, drug resistant tuberculosis, and inefficient diagnostic methods, among others.

There is now increasing evidence to support that TB prevalence in West Africa is on a continual projection in which the futuristic outcome is worrisome, considering the challenges the region continually faces. The challenges need to be addressed by selecting the most appropriate strategy for the region, and efforts should be made to improve the surveillance system. Leveraging on the public-private partnership and cost-effectiveness evaluation should also be encouraged.