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Helicobacter pylori
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Furazolidone quadruple therapy with tetracycline Bismuth subsalicylate or bismuth subcitrate two tablets and tetracycline hydrochloride (500 mg) both 4 times daily with meals and at bedtime plus furazolidone 100 mg 8-hourly with meals and PPI twice daily for 14 days.Furazolidone quadruple therapy with amoxicillin Bismuth subsalicylate or bismuth subcitrate two tablets 4 times daily with meals and at bedtime plus furazolidone 100 mg and amoxicillin 1 g 8-hourly, with meals plus a PPI twice daily for 14 days.
Peptic ulcer disease
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
Erik AJ Rauws, Guido NJ Tytgat
Bismuth-based triple therapy comprising a bismuth compound, metronidazole, and tetracycline (or amoxycillin), was used for years as ‘the standard’ therapy. This regimen is given for 14 days and can achieve eradication rates above 90%. Bismuth (colloidal bismuth subcitrate; bismuth subsalicylate) is usually given four times daily, tetracycline 500 mg four times daily, while metronidazole dosages vary from 200–500 mg three times daily. Patients with metronidazole-resistant strains treated with bis-muth-tetracycline-metronidazole for 1 or 2 weeks, showed significantly lower eradication rates than patients with metronidazole-sensitive strains, with a mean decrease in efficacy from 97% to 44%.37,38 Empiric bismuth-based triple therapy for 7 days can be used safely in areas with a known low prevalence of metronidazole resistance at relatively low cost. In areas with a high prevalence of metronidazole resistance, the course should be extended for 14 days, although better eradication rates can be achieved using alternative regimens without imidazoles or by adding acid suppression (quadruple therapy) to bismuth-based triple therapies. Interestingly, on increasing the dose of metronidazole in bismuth-based triple therapy from 375 mg to 750 mg per day, the H. pylori eradication rates increased from 52% to 84% in metronidazole-sensitive strains and in metronidazole-resistant strains from 39% to 64%.39 Bismuth-based triple therapy has a high rate of side-effects ranging from 7% to 72%,40 but only 3–3.5% of the patients have to discontinue the therapy as a result of adverse events.41 The use of bismuth-based triple therapy has declined because of its complexity (4-times daily dosing) and side-effects. Bismuth-based triple therapy is relatively cheap and can be valuable in areas where resources are limited; unfortunately, in these areas metronidazole-resistance is high, leading to poor results.
Management of antibiotic-resistant Helicobacter pylori infection: current perspective in Iran
Published in Journal of Chemotherapy, 2020
Samin Alihosseini, Reza Ghotaslou, Fatemah Sadeghpour Heravi, Zainab Ahmadian, Hamed Ebrahimzadeh Leylabadlo
In 2012, Fakheri et al. investigated the effects of a modified bismuth-containing quadruple therapy including pantoprazole, amoxicillin, and bismuth subcitrate for 2 weeks and furazolidone just during the first week on a group of patients with an unsuccessful sequential therapy with clarithromycin. They showed an eradication rate of 80.6% and 82.9% according to ITT and PP analyses, respectively.58 An alternative second-line rescue quintuple therapy with a BOTMO regimen (bismuth subcitrate, omeprazole, tetracycline, metronidazole and ofloxacin) on patients with an unsuccessful treatment with a ten-day quadruple therapy showed a high eradication rate with minimum side effects.59 Mokhtare et al. evaluated a clarithromycin-containing bismuth-based quadruple regimen as a second-line treatment in patients with gastric or DU and/or gastric erosions who had previously failed to respond to furazolidone-containing regimens. They concluded that clarithromycin-containing bismuth-based quadruple regimen can be an effective regimen as a second-line treatment.60
The protective role of autophagy in nephrotoxicity induced by bismuth nanoparticles through AMPK/mTOR pathway
Published in Nanotoxicology, 2018
Yongming Liu, Huan Yu, Xihui Zhang, Yong Wang, Zhentao Song, Jian Zhao, Haibin Shi, Ruibin Li, Yangyun Wang, Leshuai W. Zhang
However, the potential applications of bismuth nanomaterials suggest the exposure and risk of bismuth on human and environmental health. Other than bismuth nanomaterials, bismuth salts such as colloidal bismuth subcitrate (CBS) and bismuth subsalicylate have been commonly used to treat peptic ulcers (Andrews et al. 2006; Marcus, Sachs, and Scott 2015). In addition, bismuth compounds such as bismuth vanadate, bismuth nitrate, and bismuth oxychloride have been applied as the raw materials for foundation in cosmetics. However, overdose of bismuth compounds can cause acute renal failure that has been mentioned by a numerous of clinical cases (Işlek et al. 2001). For example, during the treatment of Helicobacter pylori infections, CBS overdose has been reported to result in severe nephrotoxicity, such as necrosis in the proximal tubules (Leussink et al. 2001). In addition, bismuth oxybromide (BiOBr) NPs have been utilized in semiconductor industry, but BiOBr was found to be toxic to human skin keratinocytes (Gao et al. 2015). In spite of plenty case reports on bismuth nephrotoxicity, there were very limited studies to elucidate the mechanisms of bismuth nephrotoxicity in the cellular and molecular level.
Comparison of tailored Helicobacter pylori eradication versus modified bismuth quadruple therapy in Korea: a randomized controlled trial
Published in Expert Review of Anti-infective Therapy, 2022
Jun-Hyung Cho, So Young Jin, Suyeon Park
Recently, 14-day modified bismuth-containing quadruple therapy (proton pump inhibitor, amoxicillin, metronidazole [MDZ], and bismuth subcitrate; PAM-B) was reported to have an excellent eradication rate of 96.6%, showing potential as an alternative first-line regimen for H. pylori eradication [11]. A Korean study by Bang et al. found that the treatment efficacy and safety profile of PAM-B therapy were similar to those of classic bismuth quadruple therapy (BQT) [12]. Therefore, we designed this prospective randomized controlled trial to compare the success rate, adverse drug events, and cost-effectiveness between TT using DPO-PCR and PAM-B therapy.