ArticleDigestive diseases and sciences2015
Helicobacter pylori first-line and rescue treatments in the presence of penicillin allergy.
Article in Digestive diseases and sciences, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- ACG Clinical Guideline: Treatment of Helicobacter pylori Infection.The American journal of gastroenterology · 2017Guideline
- A Review on the Progress and Strategies ofGastroenterology research and practice · 2026Review
- VTH BRAZILIAN CONSENSUS CONFERENCE ON HELICOBACTER PYLORI INFECTION.Arquivos de gastroenterologia · 2026Article
- Clinical Effectiveness of Penicillin-Free Therapies in First-Line and Rescue Treatments forAntibiotics (Basel, Switzerland) · 2025Review
- Treatment ofAntibiotics (Basel, Switzerland) · 2023Review
- A Comparison of Doxycycline and Amoxicillin Containing Quadruple Eradication Therapy for TreatingPathogens (Basel, Switzerland) · 2022Article
- Multiple Bismuth Quadruple Therapy Containing Tetracyclines Combined with Other Antibiotics andJournal of clinical medicine · 2022Review
- Treatment ofWorld journal of gastroenterology · 2021Review
- Management of Helicobacter pylori infection: The Bhubaneswar Consensus Report of the Indian Society of Gastroenterology.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2021Article
- Rifabutin for the Treatment ofPathogens (Basel, Switzerland) · 2020Review
- European Registry onAntibiotics (Basel, Switzerland) · 2020Article
- Cefuroxime, levofloxacin, esomeprazole, and bismuth as first-line therapy for eradicating Helicobacter pylori in patients allergic to penicillin.BMC gastroenterology · 2019Article
- Antibiotic resistance andUnited European gastroenterology journal · 2017Article
- Consensus on the clinical management, screening-to-treat, and surveillance of Helicobacter pylori infection to improve gastric cancer control on a nationwide scale.Helicobacter · 2017Article
- Article
- Hellenic consensus onAnnals of gastroenterologyArticle
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHelicobacter pylori eradication is a challenge in penicillin allergy.
aimTo assess the efficacy and safety of first-line and rescue treatments in patients allergic to penicillin.
methodsProspective multicenter study. Patients allergic to penicillin were given a first-line treatment comprising (a) 7-day omeprazole-clarithromycin-metronidazole and (b) 10-day omeprazole-bismuth-tetracycline-metronidazole. Rescue treatments were as follows: (a) bismuth quadruple therapy; (b) 10-day PPI-clarithromycin-levofloxacin; and (c) 10-day PPI-clarithromycin-rifabutin. Eradication was confirmed by (13)C-urea breath test. Compliance was determined through questioning and recovery of empty medication envelopes. Adverse effects were evaluated by questionnaires.
resultsIn total, 267 consecutive treatments were included. (1) First-line treatment: Per-protocol and intention-to-treat eradication rates with omeprazole-clarithromycin-metronidazole were 59 % (62/105; 95 % CI 49-62 %) and 57 % (64/112; 95 % CI 47-67 %). Respective figures for PPI-bismuth-tetracycline-metronidazole were 75 % (37/49; 95 % CI 62-89 %) and 74 % (37/50; 95 % CI (61-87 %) (p < 0.05). Compliance with treatment was 94 and 98 %, respectively. Adverse events were reported in 14 % with both regimens (all mild). (2) Second-line treatment: Intention-to-treat eradication rate with omeprazole-clarithromycin-levofloxacin was 64 % both after triple and quadruple failure; compliance was 88-100 %, with 23-29 % adverse effects (all mild). (3) Third-/fourth-line treatment: Intention-to-treat eradication rate with PPI-clarithromycin-rifabutin was 22 %.
conclusionIn allergic to penicillin patients, a first-line treatment with a bismuth-containing quadruple therapy (PPI-bismuth-tetracycline-metronidazole) seems to be a better option than the triple PPI-clarithromycin-metronidazole regimen. A levofloxacin-based regimen (together with a PPI and clarithromycin) represents a second-line rescue option in the presence of penicillin allergy.
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