PMID- 24914361
OWN - NLM
STAT- MEDLINE
DCOM- 20150413
LR  - 20220318
IS  - 2219-2840 (Electronic)
IS  - 1007-9327 (Print)
IS  - 1007-9327 (Linking)
VI  - 20
IP  - 21
DP  - 2014 Jun 7
TI  - Efficacy of tailored Helicobacter pylori eradication therapy based on antibiotic 
      susceptibility and CYP2C19 genotype.
PG  - 6400-11
LID - 10.3748/wjg.v20.i21.6400 [doi]
AB  - The cure rates of Helicobacter pylori (H. pylori) eradication therapy using a 
      proton pump inhibitor (PPI) and antimicrobial agents such as amoxicillin, 
      clarithromycin, and metronidazole are mainly influenced by bacterial 
      susceptibility to antimicrobial agents and the magnitude of the inhibition of 
      acid secretion. Annual cure rates have gradually decreased because of the 
      increased prevalence of H. pylori strains resistant to antimicrobial agents, 
      especially to clarithromycin. Alternative regimens have therefore been developed 
      incorporating different antimicrobial agents. Further, standard PPI therapy 
      (twice-daily dosing) often fails to induce a long-term increase in intragastric 
      pH > 4.0. Increasing the eradication rate requires more frequent and higher doses 
      of PPIs. Therapeutic efficacy related to acid secretion is influenced by genetic 
      factors such as variants of the genes encoding drug-metabolizing enzymes (e.g., 
      cytochrome P450 2C19, CYP2C19), drug transporters (e.g., multidrug resistance 
      protein-1; ABCB1), and inflammatory cytokines (e.g., interleukin-1beta). For 
      example, quadruple daily administration of PPI therapy potently inhibits acid 
      secretion within 24 h, irrespective of CYP2C19 genotype. Therefore, tailored H. 
      pylori eradication regimens that address acid secretion and employ optimal 
      antimicrobial agents based on results of antimicrobial agent-susceptibility 
      testing may prove effective in attaining higher eradication rates.
FAU - Sugimoto, Mitsushige
AU  - Sugimoto M
AD  - Mitsushige Sugimoto, First Department of Medicine, Hamamatsu University School of 
      Medicine, Hamamatsu 431-3192, Japan.
FAU - Furuta, Takahisa
AU  - Furuta T
AD  - Mitsushige Sugimoto, First Department of Medicine, Hamamatsu University School of 
      Medicine, Hamamatsu 431-3192, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - World J Gastroenterol
JT  - World journal of gastroenterology
JID - 100883448
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - EC 1.14.14.1 (CYP2C19 protein, human)
RN  - EC 1.14.14.1 (Cytochrome P-450 CYP2C19)
RN  - H1250JIK0A (Clarithromycin)
SB  - IM
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Clarithromycin/therapeutic use
MH  - Clinical Trials as Topic
MH  - Cytochrome P-450 CYP2C19/*genetics
MH  - Genotype
MH  - Helicobacter Infections/*drug therapy
MH  - *Helicobacter pylori
MH  - Humans
MH  - Microbial Sensitivity Tests
MH  - *Polymorphism, Genetic
MH  - Prevalence
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Treatment Outcome
PMC - PMC4047325
OTO - NOTNLM
OT  - Clarithromycin
OT  - Cytochrome P450 2C19
OT  - Helicobacter pylori
OT  - Proton pomp inhibitor
OT  - Tailored eradication therapy
EDAT- 2014/06/11 06:00
MHDA- 2015/04/14 06:00
PMCR- 2014/06/07
CRDT- 2014/06/11 06:00
PHST- 2013/11/09 00:00 [received]
PHST- 2014/01/18 00:00 [revised]
PHST- 2014/02/17 00:00 [accepted]
PHST- 2014/06/11 06:00 [entrez]
PHST- 2014/06/11 06:00 [pubmed]
PHST- 2015/04/14 06:00 [medline]
PHST- 2014/06/07 00:00 [pmc-release]
AID - 10.3748/wjg.v20.i21.6400 [doi]
PST - ppublish
SO  - World J Gastroenterol. 2014 Jun 7;20(21):6400-11. doi: 10.3748/wjg.v20.i21.6400.