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Amoxicillin–Clavulanic Acid
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Primary resistance of H. pylori to amoxicillin is increasing. In Taiwan resistance has increased from 1–2% to up to 36% in some regions (Chen et al. 2014), prompting substitution of amoxicillin–clavulanic acid in some regimens. Levofloxacin, amoxicillin–clavulanic acid 875mg/125mg twice daily and rabeprozole was more effective than clarithromycin, amoxicillin 1000mg twice daily, and rabeprozole in eradicating H. pylori (78% vs. 57.5%, p = 0.008) in a region of high amoxicillin resistance (Chen et al., 2014). Liao et al. (2015) achieved 85% eradication with 10 days of amoxicillin–clavulanic acid, ilaprazole, levofloxacin, and bismuth. Use of amoxicillin–clavulanic acid would depend on local rates of amoxicillin resistance, however, and further evaluation is required.
Iatrogenic factors of Helicobacter pylori eradication failure: lessons from the frontline
Published in Expert Review of Anti-infective Therapy, 2023
Jinliang Xie, Dingwei Liu, Jianxiang Peng, Shuang Wu, Dongsheng Liu, Yong Xie
Patients used nitroimidazoles mainly included metronidazole, tinidazole and ornidazole. Quinolones mainly include levofloxacin, antofloxacin, and moxifloxacin. We evaluated whether the dose of bismuth, antibiotics, and PPI was appropriate or not according to the ‘Fifth Chinese national consensus report on the management of Helicobacter pylori infection’ [9]. Standard doses of various drugs are defined as follows: amoxicillin 1000 mg twice a day (b.i.d), clarithromycin 500 mg b.i.d, metronidazole 400 mg thrice a day (t.i.d) or four times a day (q.i.d), tetracycline 500 mg t.i.d or q.i.d, furazolidone 100 mg b.i.d, levofloxacin 500 mg q.d or 200 mg b.i.d, esomeprazole 20 mg b.i.d, omeprazole 20 mg b.i.d, lansoprazole 30 mg b.i.d, pantoprazole 40 mg b.i.d, ilaprazole 5 mg b.i.d, and bismuth potassium citrate 220 mg b.i.d.
The pharmacotherapeutic management of duodenal and gastric ulcers
Published in Expert Opinion on Pharmacotherapy, 2022
Taraneh Mousavi, Shekoufeh Nikfar, Mohammad Abdollahi
Another significant point determining the success of eradication therapy is sufficient response to PPIs directly linked to the existence of genetic polymorphisms in CYP2C19, the primary metabolizing enzyme of PPIs. Considering this, using and developing PPIs less affected by such polymorphisms is warranted. Ilaprazole, although not approved by USFDA or EMA, is insensitive to genetic polymorphisms due to its nonenzymatic reduction. It has similar efficacy and safety, prolonged duration of action, and higher potency in suppressing gastric acid than available PPIs; hence, it is a great candidate for future development in the American and European markets.
Natural compounds and extracts as novel antimicrobial agents
Published in Expert Opinion on Therapeutic Patents, 2020
Paolo Guglielmi, Virginia Pontecorvi, Giulia Rotondi
The introduction of the proton-pump inhibitor (PPI) omeprazole, in the amount spanning from 2.5 mg to 40 mg (selected from the proton-pump inhibitors available: omeprazole, lansoprazole, dexlansoprazole, esomeprazole, pantoprazole, rabeprazole, ilaprazole and tenatoprazole), improved the efficacy of the supplement composition by reducing the quantity of stomach acid, also inhibiting the H. pylori urease [31]. Moreover, the presence of microbial biosurfactants, produced by a variety of microorganisms such as Pseudomonas spp., Bacillus spp., Candida spp., etc., enhances the antimicrobial activity of these compositions. Indeed, on one hand, these substances endowed with an amphiphilic character improve the water bioavailability of water-insoluble substances (like the oils), while on the other lead to pores formation and destabilization of the microorganism membranes thus enforcing the anti-microbial effects. Among the available biosurfactants (glycolipids, lipopeptides, flavolipids, etc.), the glycolipids such as rhamnolipids, sophorolipids (SLP), trehalose lipids, cellobiose lipids and/or mannosylerythritol lipids and the lipopeptides, including, surfactin, iturin, fengycin, arthrofactin, viscosin, amphisin and/or lichenysin, have been evaluated. SLP resulted to have the best ability to destroy biofilms, along with anti-inflammatory, tissue-healing, antibacterial and/or antioxidant properties [32]. SLP are glycolipids formed by the sophorose, consisting in two glucose molecules linked to a fatty acid by a glycosidic ether bond. Depending on the presence of a cyclic ester bond, they are categorized in the lactonic form (a cyclic ester) or the acidic form (also called linear form, due to the presence of the hydrolyzed ester bond), the former having greater antimicrobial/anti-biofilm capabilities and employed in the compositions in the amounts spanning from 5 to 20 µg/mL.