- A multicenter, randomized, prospective study of 14-day ranitidine bismuth citrate- vs. lansoprazole-based triple therapy for the eradication of Helicobacter pylori in dyspeptic patients. [Randomized Controlled Trial]
- TJTurk J Gastroenterol 2013; 24(4):316-21
- CONCLUSIONS: Ranitidine bismuth citrate-based regimen is at least as effective and tolerable as the classical proton-pump inhibitor-based regimen, but none of the therapies could achieve the recommendable eradication rate.
- Treatment of gastric MALT lymphoma with a focus on Helicobacter pylori eradication. [Review]
- IJInt J Hematol 2013; 97(6):735-42
- Mucosa-associated lymphoid tissue (MALT) lymphoma is an indolent disease with a prolonged clinical course that most often involves the stomach. Clinically, for Helicobacter pylori-positive low-grade …
Mucosa-associated lymphoid tissue (MALT) lymphoma is an indolent disease with a prolonged clinical course that most often involves the stomach. Clinically, for Helicobacter pylori-positive low-grade MALT lymphoma, antibiotics have been used as the first-line treatment. The recommended anti-Helicobacter triple drug therapy includes a proton pump inhibitor (or ranitidine bismuth citrate), clarithromycin, and amoxicillin (or metronidazole). Considering the difficulty involved with confirming histological remission and the lack of systemic endoscopic follow-up, much work remains to be done in this area. This review describes MALT lymphoma treatment methods and their efficacy, highlights results of the newest studies, and proposes avenues toward future developments in this field.
- [Detection of Helicobacter pylori and antimicrobial resistance in gastric biopsy specimens]. [Journal Article]
- MBMikrobiyol Bul 2012; 46(3):398-409
- Helicobacter pylori is reported as the etiological agent of gastritis, gastric and duodenal ulcer, gastric adenoid carcinoma and mucosa-associated lymphoid tissue lymphoma. In the diagnosis of H.pylo…
Helicobacter pylori is reported as the etiological agent of gastritis, gastric and duodenal ulcer, gastric adenoid carcinoma and mucosa-associated lymphoid tissue lymphoma. In the diagnosis of H.pylori infections invasive (culture, histopathological examination, rapid urease test and molecular tests) and non-invasive (urea breath test, serological tests, stool culture and stool antigen/nucleic acid tests) methods may be used. Clarithromycin, amoxicillin and combination of metronidazole and protonpump inhibitor or ranitidine bismuth citrate triple treatment protocol is applied in order to treat and eradicate the infection. However, increasing rates of antibiotic resistance among H.pylori strains reduces the success of eradication therapy. The aim of this study was to investigate the presence of H.pylori in the gastric antral biopsy specimens and to determine the antimicrobial resistance of the isolates. A total of 149 gastric antral biopsy specimens obtained from patients (age range: 17-83 years; 73 were male) who admitted to Mersin University Faculty of Medicine Department of Internal Medicine Gastroenterology clinic with dyspeptic complaints were included in the study. H.pylori presence was investigated by culture, polymerase chain reaction (PCR) and urease test from gastric biopsy specimens, and H.pylori-specific antigen (HpSA) was investigated by ELISA in the stool samples of patients. Resistance to tetracycline, amoxicillin, metronidazole and levofloxacin was determined with E-test method. Clarithromycin resistance was determined both by E-test and PCR-RFLP (restriction fragment length polymorphism) methods. H.pylori was detected in 29.6% (43/145) of patients with culture, 55.2% (80/145) of patients with urease test, 57% (65/114) of patients with HpSA test and 71.3% (102/143) of patients with PCR. The sensitivity and specificity of culture, PCR, HpSA and urease tests were determined as 52.4% and 100%, 96.3% and 62.3%, 80.3% and 81.4%, 86.6% and 85.7%, respectively. According to the E-test results, resistance to clarithromycin was 18.2%, to tetracycline 9.1%, to metronidazole 45.5%, to levofloxacin 18.2% and no resistance was determined to amoxicillin. Clarithromycin resistance was searched in 94 of PCR positive 102 samples, and 17 (18.1%) of them yielded clarithromycin resistance. Of them 11 (64.7%) harbored A2144G (at 2144. nucleotide), and 6 (%35.3) harbored A2143G (at 2143. nucleotide) point mutations. In our study, PCR was determined as the most sensitive method, however due to its low specificity, the results should be confirmed with at least one of the other methods. The specificity of culture method was high, but sensitivity was found to be quite low compared with other methods. The sensitivity and specificity of urease and HpSA tests were found to be similar. In conclusion, in cases which endoscopy could not be done, non-invasive, rapid and practical HpSA method can be used in diagnosis and monitorization of the treatment. In the case of treatment failure, culture should be performed for antibiotic susceptibility testing of the isolate.
- Double-liposome-based dual-drug delivery system as vectors for effective management of peptic ulcer. [Journal Article]
- JLJ Liposome Res 2012; 22(3):205-14
- The aim of the present investigation was to prepare and evaluate a vesicular dual-drug delivery system for effective management of the mucosal ulcer. Inner encapsulating and double liposomes were pre…
The aim of the present investigation was to prepare and evaluate a vesicular dual-drug delivery system for effective management of the mucosal ulcer. Inner encapsulating and double liposomes were prepared by the glass-bead and reverse-phase evaporation methods, respectively. The formulation consisted of inner liposomes bearing ranitidine bismuth citrate (RBC) and outer liposomes encapsulating amoxicillin trihydrate (AMOX). The optimized inner liposomes and double liposomes were extensively characterized for vesicle size, morphology, zeta potential, vesicles count, entrapment efficiency, and in vitro drug release. In vitro, the double liposomes demonstrated a sustained release of AMOX and RBC of 93.6 ± 1.9 and 84.1 ± 0.9%, respectively, at the end of 144 hours. Ex vivo studies were conducted on Helicobacter pylori (ATCC26695) bacterial cell lines. Double liposomes showed a more enhanced percent H. pylori growth inhibition than the plain drug combination. Further, in vivo studies illustrated enhanced antisecretory and ulcer-protective activity of double liposomes, as compared to the plain drug combination. Microscopic studies also supported the ulcer-protective action of the formulation. Thus, it may be concluded that double liposomes are instrumental in reducing gastric secretions and targeting ulcer sites with the interception of minimal side effects, thus suggesting their potential in ulcer therapy.
- Effectiveness of ranitidine bismuth citrate and proton pump inhibitor based triple therapies of Helicobacter pylori in Turkey. [Journal Article]
- LJLibyan J Med 2011; 6
- CONCLUSIONS: Ranitidine bismuth citrate and/or rabeprazole based triple therapies must be preferred for the first-line treatment of H. pylori infection.
- Double liposomes mediated dual drug targeting for treatment of Helicobacter pylori infections. [Journal Article]
- PPharmazie 2011; 66(5):368-73
- In the present study the potential of phosphatidylethanolamine (PE) lipid anchored double liposomes (DL) to incorporate two drugs in a single system is exploited as a tool to augment the H. pylori er…
In the present study the potential of phosphatidylethanolamine (PE) lipid anchored double liposomes (DL) to incorporate two drugs in a single system is exploited as a tool to augment the H. pylori eradication rate. Preparation of DL involves two steps, first formation of primary (inner) liposomes by thin film hydration method containing one drug, then addition of suspension of inner liposomes on thin film of lipid containing the other drug. The success of formation of DL was characterized by optical and transmission electron microscopy. Quantitation of DL-bacterial interaction was evaluated in terms of percent growth inhibition (%GI) on reference strain of H. pylori ATCC 26695. To confirm specific binding efficacy of DL to H. pylori PE surface receptor we performed an agglutination assay. Agglutination in DL treated H. pylori suspension suggested selectivity of DL towards the PE surface receptor of H. pylori. Monotherapy is generally not recommended for treatment of a H. pylori infection due to the danger of development of resistance and unacceptably low eradication rates. Therefore combination therapy with amoxicillin trihydrate (AMOX) as anti-H. pylori agent and ranitidine bismuth citrate (RBC) as antisecretory agent were selected for the study with an expectation that this dual-drug delivery approach will exert acceptable anti-H. pylori activity.
- Ranitidine bismuth citrate in the first-line of Helicobacter pylori treatment. [Letter]
- PMPanminerva Med 2011; 53(2):138
- Randomised clinical trial: Helicobacter pylori eradication is associated with a significantly increased body mass index in a placebo-controlled study. [Randomized Controlled Trial]
- APAliment Pharmacol Ther 2011; 33(8):922-9
- CONCLUSIONS: Body mass index increased significantly following randomisation to H. pylori eradication therapy, possibly due to resolution of dyspepsia.
- Effectiveness of different treatment regimens in helicobacter pylori eradication: ten-year experience of a single institution. [Journal Article]
- TJTurk J Gastroenterol 2010; 21(3):218-23
- CONCLUSIONS: In Group 1, the eradication rate was lower than 80%. In Groups 34, the eradication rate increased to over 80%. The colloidal bismuth subcitrate, metronidazole and tetracycline regimen (Group 2) was the most successful, with a rate of 92.3%. The eradication rate in the consecutive regimen group (Group 6) did not reach the recommended level (higher than 80-85%).
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- Sequential therapy for Helicobacter pylori eradication. [Journal Article]
- TJTurk J Gastroenterol 2010; 21(3):206-11
- CONCLUSIONS: High rates of eradication were achieved in both groups in the 4th week evaluation. It was observed at the follow-up performed one year later that the eradication achieved with sequential therapy persisted in 77% of the patients treated.