Role of Bismuth in the Eradication of Helicobacter pylori.
Am J Ther
; 24(6): e751-e757, 2017.
Article
em En
| MEDLINE
| ID: mdl-26808355
ABSTRACT
Bismuth salts exert their activity within the upper gastrointestinal tract through action of luminal bismuth. Bismuth exerts direct bactericidal effect on Helicobacter pylori by different ways forms complexes in the bacterial wall and periplasmic space, inhibits different enzymes, ATP synthesis, and adherence of the bacteria to the gastric mucosa. Bismuth also helps ulcer healing by acting as a barrier to the aggressive factors and increasing mucosal protective factors such as prostaglandin, epidermal growth factor, and bicarbonate secretion. To date, no resistance to bismuth has been reported. Also synergism between bismuth salts and antibiotics was present. It was shown that metronidazole and clarithromycin resistant H. pylori strains become susceptible if they are administered together with bismuth. Bismuth-containing quadruple therapy was recommended both by the Second Asia-Pacific Consensus Guidelines and by the Maastricht IV/Florence Consensus Report as an alternative first choice regimen to standard triple therapy, in areas with low clarithromycin resistance, and it is recommended as the first-line therapeutic option in areas with a high prevalence of clarithromycin resistance. Greater than 90% eradication success can be obtained by bismuth-containing quadruple therapy. Choosing bismuth as an indispensable part of first-line therapy is logical as both metronidazole and clarithromycin resistances can be overcome by adding bismuth to the regimen.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Bismuto
/
Helicobacter pylori
/
Infecções por Helicobacter
/
Erradicação de Doenças
/
Antiácidos
/
Antibacterianos
Tipo de estudo:
Guideline
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Am J Ther
Assunto da revista:
TERAPEUTICA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Turquia