OBJECTIVEHelicobacter pylori (H. pylori) eradication remains a challenge with increasing antibiotic resistance. Hybrid therapy has attracted widespread attention because of initial report with good efficacy and safety. However, many issues on hybrid therapy are still unclear such as the eradication efficacy, safety, compliance, influencing factors, correlation with antibiotic resistance, and comparison with other regimens. Therefore, a comprehensive review on the evidence of hybrid therapy for H. pylori infection was conducted.

DATA SOURCESThe data used in this review were mainly from PubMed articles published in English up to September 30, 2015, searching by the terms of "Helicobacter pylori" or "H. pylori", and "hybrid".

STUDY SELECTIONClinical research articles were selected mainly according to their level of relevance to this topic.

RESULTSTotally, 1871 patients of 12 studies received hybrid therapy. The eradication rates were 77.6-97.4% in intention-to-treat and 82.6-99.1% in per-protocol analyses. Compliance was 93.3-100.0%, overall adverse effects rate was 14.5-67.5%, and discontinued medication rate due to adverse effects was 0-6.7%. H. pylori culture and sensitivity test were performed only in 13.3% patients. Pooled analysis showed that the eradication rates with dual clarithromycin and metronidazole susceptible, isolated metronidazole or clarithromycin resistance, and dual clarithromycin and metronidazole resistance were 98.5%, 97.6%, 92.9%, and 80.0%, respectively. Overall, the efficacy, compliance, and safety of hybrid therapy were similar with sequential or concomitant therapy. However, hybrid therapy might be superior to sequential therapy in Asians.

CONCLUSIONSHybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions. Dual clarithromycin and metronidazole resistance were the key factor to efficacy. Hybrid therapy was similar to sequential or concomitant therapy in the efficacy, safety, and compliance.

Clarithromycin ; administration & dosage ; adverse effects ; Drug Resistance, Bacterial ; Drug Therapy, Combination ; Helicobacter pylori ; drug effects ; Humans ; Medication Adherence ; Metronidazole ; administration & dosage ; adverse effects ; Proton Pump Inhibitors ; administration & dosage

No abstract available.
Antineoplastic Agents/administration & dosage ; *Antineoplastic Combined Chemotherapy Protocols ; Clarithromycin/administration & dosage ; Cyclophosphamide/administration & dosage ; Humans ; Lymphoma, Follicular/*drug therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local/*drug therapy ; Prednisolone/administration & dosage ; Protein Synthesis Inhibitors/administration & dosage

OBJECTIVETo evaluate the clinical effect of proton pump inhibitor-based triple therapy combined with Saccharomyces boulardii in the treatment of Helicobacter pylori (Hp) infection among children in terms of Hp eradication rate and incidence of adverse events.

METHODSA prospective randomised controlled study was conducted on 240 children with a confirmed diagnosis of Hp infection. These patients were randomized into triple therapy (n=120) and probiotics groups (n=120). The triple therapy group received amoxicillin [40 mg/(kg·d), Tid], clarithromycin [15 mg/(kg·d), Bid] and omeprazole [0.7-0.8 mg/(kg·d), Qd], while the probiotics group received Saccharomyces boulardii (250 mg, Bid) in addition to triple therapy. The course of treatment was 14 days in both groups. The adverse events in subjects were recorded by their parents during treatment. Hp eradiation was evaluated by (13)C breath test at 4 weeks after treatment, and the eradication rate and incidence of adverse events were compared between the two groups.

RESULTSThe Hp eradication rates were 75.8% (91/120) in the triple therapy group and 85% (102/120) in the probiotics group (P>0.05). Compared with the triple therapy group, the probiotics group had nonsignificantly lower incidence of nausea, vomiting, and abdominal pain (P>0.05) and significantly lower incidence of stomatitis, constipation and diarrhea (P<0.05).

CONCLUSIONSTriple therapy combined with Saccharomyces boulardii cannot significantly increase Hp eradication rate, but can significantly reduce the incidence of stomatitis, constipation, and diarrhea during treatment.

Amoxicillin ; administration & dosage ; Child ; Child, Preschool ; Clarithromycin ; administration & dosage ; Combined Modality Therapy ; Drug Therapy, Combination ; Female ; Helicobacter Infections ; therapy ; Helicobacter pylori ; Humans ; Male ; Omeprazole ; administration & dosage ; Probiotics ; administration & dosage ; Prospective Studies ; Saccharomyces

Statins are commonly used in the treatment of hyperlipidaemia. Although the benefits of statins are well-documented, they have the potential to cause myopathy and rhabdomyolysis due to the complex interactions of drugs, comorbidities and genetics. The cytochrome P450 family consists of major enzymes involved in drug metabolism and bioactivation. This article aims to highlight drug interactions involving statins, as well as provide updated recommendations and approaches regarding the safe and appropriate use of statins in the primary care setting.
Aged ; Clarithromycin ; administration & dosage ; Colchicine ; administration & dosage ; Creatine Kinase ; metabolism ; Cytochrome P-450 CYP3A ; metabolism ; Drug Interactions ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; administration & dosage ; Lovastatin ; administration & dosage ; Muscle Weakness ; chemically induced ; Muscles ; drug effects ; Myalgia ; chemically induced ; Patient Safety

OBJECTIVETo study the efficacy of esomeprazole-based 1 week or 2 weeks triple therapy for Helicobactor pylori (H. pylori) infection in children.

METHODSOne hundred and five children with H. pylori infection identified by 13C-UBT were randomly assigned into Group A (n=60) and Group B (n=45). The patients of the two groups were administered with 1 week or 2 weeks triple therapy consisting of esomeprazole, clarithromycin and amoxillin, respectively. They were followed up four weeks after drug withdrawal.

RESULTSRecurrent abdominal pain was relieved in all of patients. Fifty-five patients (91.7%) showed 13C-UBT negative in Group A and 42 (93.3%) presented negative in Group B. There was no significant difference in the eradication rate of H. pylori.

CONCLUSIONSEsomeprazole-based triple therapy for H. pylori infection is effective in children. The efficacy of esomeprazole-based 1 week or 2 weeks triple therapy for this disorder does not appear to be different.

Adolescent ; Amoxicillin ; administration & dosage ; Anti-Bacterial Agents ; adverse effects ; Anti-Ulcer Agents ; administration & dosage ; Child ; Child, Preschool ; Clarithromycin ; administration & dosage ; Drug Therapy, Combination ; Esomeprazole ; administration & dosage ; Female ; Helicobacter Infections ; drug therapy ; Helicobacter pylori ; Humans ; Male

PURPOSE: Mycobacterium abscessus belongs to the group of rapid-growing atypical mycobacterium. The organism is ubiquitous and is found in soil, dust, and water. Although it rarely causes disease in humans, Mycobacterium abscessus has been associated with soft tissue infection. To the best of our knowledge, this is the first case report of facial soft tissue Mycobacterium abscessus infection in a healthy child in Korea. METHODS: A 12-year-old girl presented with an erythematous skin lesion with serous discharge on her chin, which had been present for 3 weeks. On her history, she had a laceration wound on her chin at public bath and the lesion was repaired at emergency department immediately. Although conventional soft tissue infecton treatment, her lesion remains unhealed state and had serous discharge for 2 months. Moreover, we found a 1cm sized nodular mass on her chin. Therefore we performed excision operation and referred the specimen to the laboratory for microbial and histopathologic study. RESULTS: Pathology report confirmed the mass was enlarged lymph node with chronic necrotizing granulomatous inflammation with central microabscess. Non-Tuberculous mycobacterium identification test through tissue specimen resulted Mycobacterium abscessus. We prescribed clarithromycin for three weeks by oral administration as well as performed wound debridement and mass excision via previous wound. This way, her lesion appeared to be complete healing with minimal scarring. There were no evidence of inflammation sign or palpable mass. CONCLUSION: Although the prevalence is rare, Mycobacterium abscessus infections of soft tissue should be considered even in a healthy child with a lesion caused by trauma or which fails to respond to conventional treatment.
Administration, Oral ; Baths ; Child ; Chin ; Cicatrix ; Ciprofloxacin ; Clarithromycin ; Debridement ; Dust ; Emergencies ; Humans ; Inflammation ; Korea ; Lacerations ; Lymph Nodes ; Mycobacterium ; Nontuberculous Mycobacteria ; Organotechnetium Compounds ; Prevalence ; Skin ; Soft Tissue Infections ; Soil

The study is to prepare taste masking and enteric-coated clarithromycin granules by melting and fluid bed coating technology. Clarithromycin and matrix materials were melted at a certain temperature, and then made into particles by fluidized bed coating. X-ray powder diffraction and scanning electron microscopy were used to identify the crystal and morphology of drug loading granules. In vitro dissolution method was used for the observation of the drug release behavior. The results showed that the drug particles size range was 0.2 - 0.6 mm; the crystal form of clarithromycin in the granule did not change; enteric-coated granules accumulated release in 0.1 mol L(-1) hydrochloric acid in 2 h was less than 10%, while in pH 6.8 phosphate buffer in 1 h was more than 80%. The taste masking and enteric-coated clarithromycin granules not only have good taste masking effect, but also have a good release behavior. It is expected to have better clinical application.
Clarithromycin ; administration & dosage ; chemistry ; Crystallization ; Drug Carriers ; Drug Compounding ; methods ; Excipients ; chemistry ; Microscopy, Electron, Scanning ; Particle Size ; Tablets, Enteric-Coated ; Taste ; Technology, Pharmaceutical ; methods ; X-Ray Diffraction

OBJECTIVE: To observe the clinical treatment effectiveness of clarithromycin for naso-sinusitis after nasopharyngeal carcinoma radiotherapy. METHOD: Twenty-four cases of naso-sinusitis after one year nasopharyngeal carcinoma radiotherapy were treated with the oral clarithromycin of small dosage (250 mg everyday). The course of treatment were for 12 to 20 weeks. The treatment effectiveness were evaluated with the chronic naso-sinusitis visual analog quality table mark system (VAS) and Lund-Mackay nasal sinuses CT image mark system before and after treatment. RESULT: The VAS mark and CT image mark have significant deviation (P < 0.01) among pretherapy, post-treatment and 6 months after drug withdrawal. No significant deviation was found(P > 0.05) between post treatment and 6 months after drug withdrawal. The treatment effectiveness was judged for very good is 9 cases, for the good is 11 cases and for the bad is 4 cases. CONCLUSION The clarithromycin of small dosage for long-term treatment of naso-sinusitis after nasopharyngeal carcinoma radiotherapy has positive clinical treatment effectiveness, which is a better treatment method.
Adult ; Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; Clarithromycin ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Radiography ; Sinusitis ; drug therapy ; etiology ; Treatment Outcome

Triple therapy with bismuth subsalicylate, amoxicillin, metronidazole (BAM) or with omeprazole, amoxicillin, clarithromycin (OAC) has been commonly used for the eradication of Helicobacter pylori infection. We compared the efficacy of these triple therapies in children with H. pylori infection. We retrospectively analyzed results in 233 children with H. pylori infection and treated with OAC (n=141) or BAM (n=92). Overall eradication rates of triple therapy with OAC and BAM were 74% and 85%, respectively, which showed no statistical difference. Our study showed that the triple therapy with BAM was more effective for the first-line eradication of H. pylori infection in Korean children, but has no statistical difference with OAC regimen.
Treatment Outcome ; Salicylates/*administration & dosage ; Retrospective Studies ; Organometallic Compounds/*administration & dosage ; Omeprazole/*administration & dosage ; Metronidazole/*administration & dosage ; Male ; Humans ; Helicobacter pylori/*drug effects ; Helicobacter Infections/*drug therapy ; Female ; Drug Combinations ; Clarithromycin/*administration & dosage ; Child, Preschool ; Child ; Bismuth/*administration & dosage ; Anti-Bacterial Agents/administration & dosage ; Amoxicillin/*administration & dosage ; Adolescent

Triple therapy with bismuth subsalicylate, amoxicillin, metronidazole (BAM) or with omeprazole, amoxicillin, clarithromycin (OAC) has been commonly used for the eradication of Helicobacter pylori infection. We compared the efficacy of these triple therapies in children with H. pylori infection. We retrospectively analyzed results in 233 children with H. pylori infection and treated with OAC (n=141) or BAM (n=92). Overall eradication rates of triple therapy with OAC and BAM were 74% and 85%, respectively, which showed no statistical difference. Our study showed that the triple therapy with BAM was more effective for the first-line eradication of H. pylori infection in Korean children, but has no statistical difference with OAC regimen.
Treatment Outcome ; Salicylates/*administration & dosage ; Retrospective Studies ; Organometallic Compounds/*administration & dosage ; Omeprazole/*administration & dosage ; Metronidazole/*administration & dosage ; Male ; Humans ; Helicobacter pylori/*drug effects ; Helicobacter Infections/*drug therapy ; Female ; Drug Combinations ; Clarithromycin/*administration & dosage ; Child, Preschool ; Child ; Bismuth/*administration & dosage ; Anti-Bacterial Agents/administration & dosage ; Amoxicillin/*administration & dosage ; Adolescent