Show simple item record

dc.rights.licenseAtribución-NoComercial-SinDerivadas 4.0 Internacional
dc.contributor.advisorOtero Regino, William
dc.contributor.authorBuitrago Laguado, Eddy Johanna
dc.contributor.authorRuiz Linares, Carlos Eduardo
dc.date.accessioned2021-03-25T14:41:44Z
dc.date.available2021-03-25T14:41:44Z
dc.date.issued2021-01-25
dc.identifier.urihttps://repositorio.unal.edu.co/handle/unal/79373
dc.description.abstractIntroducción: Helicobacter pylori (H. pylori) afecta al 50% de la humanidad. Los tratamientos usuales han disminuido su eficacia por aumento de resistencia a los antibióticos excepto amoxicilina, tetraciclina, furazolidona y bismuto. Recientemente hay nuevo interés en la terapia dual con altas dosis de inhibidores de bomba de protones (IBP) y amoxicilina como terapia inicial y como recate. En nuestro medio no hay estudios al respecto. Objetivo:. Determinar la eficacia de la terapia dual con altas dosis de IBP y amoxicilina para erradicar H. pylori. Materiales y métodos: Estudio cuasi-experimental realizado entre diciembre de 2019 y julio de 2020 en mayores de 18 años, H. pylori identificado histológicamente. Todos recibieron esomeprazol 40 mg media hora antes de desayuno, almuerzo y cena mas amoxicilina 1 gramo oral cada 8 horas por 14 días. La erradicación se determinó con antígenos fecales (OnSiteTM H. pylori Biotech Inc) después de 4 semanas del tratamiento. Resultados. Se incluyeron 108 pacientes, edad promedio de 67 años, 70% mujeres. La erradicación por protocolo (PP) e intención de tratar (ITT) fue de 86% (IC95% 79,4% – 92,5%). En los pacientes con tratamiento previo (26%) la eficacia fue del 85.7% (IC95% 71,8% – 99,5%). Eventos adversos fueron leves en 31%, especialmente náuseas (16%) y bloating (14%). En ninguno se suspendió el tratamiento. Conclusión. La terapia dual es eficaz, fácil de administrar, con pocos efectos adversos. Sería una buena opción en nuestro medio como terapia inicial y como rescate. Se requieren estudios más grandes para verificar nuestros resultados.
dc.description.abstractIntroduction: Helicobacter pylori (H. pylori) affects 50% of humans. The usual treatments have decreased their effectiveness due to increased resistance to antibiotics except amoxicillin and tetracycline, furazolidone. Recently there is new interest in dual therapy with high doses of proton pump inhibitors (PPIs) and amoxicillin as initial therapy and rescue. In Colombia there are no studiesabout it. . Objective. To determine the efficacy of dual therapy with high doses of PPIs and amoxicillin to eradicate H. pylor infection. Materials and Methods. Quasi-experimental study between December 2019 and July 2020 in people over 18 years of age, H. pylori was identified by histologically. All subjects received esomeprazole 40 mg half an hour before breakfast, lunch and dinner plus amoxicillin 1 gram orally every 8 hours for 14 days. The sample calculation required 84 subjects. H. pylori eradication was determined by fecal antigens (OnSiteTM H. pylori Biotech Inc) after 4 weeks of finishing the treatment. Results. 108 subjects were included. 70% were women with an average age of 67 years old. The eradication rate of H. pylori by protocol (PP) and by ITT was 86% (95% CI 79.4% - 92.5%). In subjects with history of H. pylori treatment (26%), the efficacy of therapy was 85.7% (95% CI 71.8% - 99.5%). Mild adverse events in 31%, especially nausea (16%) and bloating (14%). In none of them was treatment suspended. Conclusion: Dual therapy is effective, easy to administer, with few adverse effects. It would be an excellent option in Colombia initial therapy and as a rescue. However larger studies are required to verify our results.
dc.format.extent1 recurso en línea (45 páginas)
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.publisherUniversidad Nacional de Colombia
dc.rightsDerechos reservados - Universidad Nacional de Colombia
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc610 - Medicina y salud
dc.titleEficacia de la terapia dual para erradicación de H. pylori en una población colombiana
dc.typeTrabajo de grado - Especialidad Médica
dc.rights.spaAcceso abierto
dc.type.driverinfo:eu-repo/semantics/bachelorThesis
dc.type.versioninfo:eu-repo/semantics/acceptedVersion
dc.publisher.programBogotá - Medicina - Especialidad en Medicina Interna
dc.publisher.placeBogotá
dc.relation.referencesHooi JKY, Lai WY, Ng WK, et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017;153(2):420-429. doi:10.1053/j.gastro.2017.04.022
dc.relation.referencesKalali B, Formichella L, Gerhard M. Diagnosis of Helicobacter pylori: Changes towards the Future. Diseases. 2015;3(3):122-135. doi:10.3390/diseases3030122
dc.relation.referencesMalfertheiner P, Megraud F, O’Morain C, et al. Management of helicobacter pylori infection-the Maastricht V/Florence consensus report. Gut. 2017;66(1):6-30. doi:10.1136/gutjnl-2016-312288
dc.relation.referencesHu Q, Zhang Y, Zhang X, Fu K. Gastric mucosa-associated lymphoid tissue lymphoma and Helicobacter pylori infection: A review of current diagnosis and management. Biomark Res. 2016;4(1):1-9.
dc.relation.referencesSugano K, Tack J, Kuipers EJ, et al. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015;64(9):1353-1367.
dc.relation.referencesGisbert JP, Molina-Infante J, Amador J, et al. IV Conferencia Española de Consenso sobre el tratamiento de la infección por Helicobacter pylori. Gastroenterol Hepatol. 2016;39(10):697-721.
dc.relation.referencesOtero R W, Gómez Z M, Otero P L, Trespalacios R A. Helicobacter pylori: ¿cómo se trata en el 2018? Rev Gastroenterol Peru. 2018;38(1):54-63.
dc.relation.referencesMolina-Infante J, Shiotani A. Practical Aspects in Choosing a Helicobacter pylori Therapy. Gastroenterol Clin North Am. 2015;44(3):519-535. doi:10.1016/j.gtc.2015.05.004
dc.relation.referencesCamargo MC, García A, Riquelme A, et al. Systematic Review in Latin America. Am J Gastroenterol. 2014;109(4):485-495. doi:10.1038/ajg.2014.24.
dc.relation.referencesLiao J, Zheng Q, Liang X, et al. Effect of fluoroquinolone resistance on 14-day levofloxacin triple and triple plus bismuth quadruple therapy. Helicobacter. 2013;18(5):373-377.
dc.relation.referencesLiang X, Xu X, Zheng Q, et al. Efficacy of bismuth-containing quadruple therapies for clarithromycin-, metronidazole-, and fluoroquinolone-resistant helicobacter pylori infections in a prospective study. Clin Gastroenterol Hepatol. 2013;11(7):802-807
dc.relation.referencesHenao Riveros SC, Quiroga A, Martínez Marín JD, Otero Regino W. Resistencia primaria a la claritromicina en aislamientos de Helicobacter pylori. Rev colomb gastroenterol. 2009;24(2):110-114.
dc.relation.referencesArévalo A, Otero W, Trespalacios AA. Helicobacter pylori: resistencia múltiple en pacientes de Bogotá , Colombia. Biomédica. 2019;39:125-134.
dc.relation.referencesTrespalacios-Rangél AA, Otero W, Arévalo-Galvis A, Poutou-Piñales RA, Rimbara E, Graham DY. Surveillance of levofloxacin resistance in helicobacter pylori isolates in Bogotá-Colombia (2009-2014). PLoS One. 2016;11(7):1-10.
dc.relation.referencesGraham DY, Shiotani A. Newer concepts regarding resistance in the treatment Helicobacter pylori infections. Nat Clin Pr Gastroenterol Hepatol. 2008;5(6):321-331.
dc.relation.referencesGisbert JP, McNicholl AG. Optimization strategies aimed to increase the efficacy of H. pylori eradication therapies. Helicobacter. 2017;22(4):1-13.
dc.relation.referencesVilloria A, Garcia P, Calvet X, Gisbert JP, Vergara M. Meta-analysis: High-dose proton pump inhibitors vs. standard dose in triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther. 2008;28(7):868-877.
dc.relation.referencesYu L, Luo L, Long X, et al. High-dose PPI-amoxicillin dual therapy with or without bismuth for first-line Helicobacter pylori therapy: A randomized trial. Helicobacter. 2019;24(4):1-7.
dc.relation.referencesHu J. Optimized high-dose amoxicillin dual therapies fail to achieve high cure rates in China. Saudi J Gastroenterol. 2017;23(5):275-280.
dc.relation.referencesBayerdörffer E, Miehlke S, Mannes GA, et al. Double-blind trial of omeprazole and amoxicillin to cure Helicobacter pylori infection in patients with duodenal ulcers. Gastroenterology. 1995;108(5):1412-1417.
dc.relation.referencesBayerdörffer E, Rudolph B, Neubauer A, et al. Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. Lancet. 1995;345(8965):1591-1594.
dc.relation.referencesMalfertheiner P. Current European concepts in the management of Helicobacter pylori infection. The Maastricht consensus report. Gut. 1997;41(1):8-13.
dc.relation.referencesGraham D, Lu H, Shiotani A. Failure of optimized dual proton pump inhibitor amoxicillin therapy: What now? Saudi J Gastroenterol. 2017;23(5):265-267.
dc.relation.referencesYang J, Zhang Y, Fan L, et al. Eradication Efficacy of Modified Dual Therapy Compared with Bismuth-Containing Quadruple Therapy as a First-Line Treatment of Helicobacter pylori. Am J Gastroenterol. 2019;114(3):437-445.
dc.relation.referencesYang JC, Lin CJ, Wang HL, et al. High-dose dual therapy is superior to standard first-line or rescue therapy for helicobacter pylori infection. Clin Gastroenterol Hepatol. 2015;13(5):895-905.e5
dc.relation.referencesScott D, Weeks D, Melchers K, Sachs G. The life and death of Helicobacter pylori. Gut. 1998;43(SUPPL. 1):56-60.
dc.relation.referencesEl Rouby N, Lima JJ, Johnson JA. Proton pump inhibitors: from CYP2C19 pharmacogenetics to precision medicine. Expert Opin Drug Metab Toxicol. 2018;14(4):447-460.
dc.relation.referencesSim SC, Risinger C, Dahl ML, et al. A common novel CYP2C19 gene variant causes ultrarapid drug metabolism relevant for the drug response to proton pump inhibitors and antidepressants. Clin Pharmacol Ther. 2006;79(1):103-113.
dc.relation.referencesDeshpande N, V. S, Ravi RK, et al. Rapid and ultra-rapid metabolizers with CYP2C19*17 polymorphism do not respond to standard therapy with proton pump inhibitors. Meta Gene. 2016;9:159-164.
dc.relation.referencesArévalo Galvis A, Trespalacios Rangel AA, Otero Regino W. Personalized therapy for Helicobacter pylori: CYP2C19 genotype effect on first-line triple therapy. Helicobacter. 2019;24(3):1-11.
dc.relation.referencesSuzuki S, Gotoda T, Kusano C, et al. day vonoprazan and low- ­ dose amoxicillin dual therapy as first- ­ line Helicobacter pylori treatment : a multicentre randomised trial in Japan. 2020:1-8.
dc.relation.referencesDixon MF, Genta RM, Yardley HJ et al. Classification and grading of gastritis. The updated Sydney System. Am J Surg Pathol. 1996;20(10):1161-1181.
dc.relation.referencesRugge M, Correa P, Di Mario F, et al. OLGA staging for gastritis: A tutorial. Dig Liver Dis. 2008;40(8):650-658.
dc.relation.referencesOtero R. W, Trespalacios R. AA, Otero P. L, et al. Guía de práctica clínica para el diagnóstico y tratamiento de la infección por Helicobacter pylori en adultos. Rev Colomb Gastroenterol. 2015;30:17-33.
dc.relation.referencesFarmalatina. Prueba Rápida OnSite H. pylori Ag -Casete (Muestra Fecal). En: https://www.farmalatina.cl/wp-content/uploads/2020/04/PI-R0192C-Spanish-Rev-H. pylori.pdf
dc.relation.referencesTang HL, Li Y, Hu YF, Xie HG, Zhai S Di. Effects of CYP2C19 Loss-of-Function Variants on the Eradication of H. pylori Infection in Patients Treated with Proton Pump Inhibitor-Based Triple Therapy Regimens: A Meta-Analysis of Randomized Clinical Trials. PLoS One. 2013;8(4).
dc.relation.referencesGao CP, Zhang D, Zhang T, et al. PPI-amoxicillin dual therapy for Helicobacter pylori infection: An update based on a systematic review and meta-analysis. Helicobacter. 2020;25(4):1-8.
dc.relation.referencesTai WC, Liang CM, Kuo CM, et al. A 14 day esomeprazole- And amoxicillin-containing high-dose dual therapy regimen achieves a high eradication rate as first-line anti-Helicobacter pylori treatment in Taiwan: a prospective randomized trial. J Antimicrob Chemother. 2019;74(6):1718-1724.
dc.relation.referencesZhu YJ, Zhang Y, Wang TY, et al. High dose PPI-amoxicillin dual therapy for the treatment of Helicobacter pylori infection: a systematic review with meta-analysis. Therap Adv Gastroenterol. 2020;13:1-12.
dc.relation.referencesPan KF, Zhang L, Gerhard M, et al. A large randomised controlled intervention trial to prevent gastric cancer by eradication of Helicobacter pylori in Linqu County, China: Baseline results and factors affecting the eradication. Gut. 2016;65(1):9-18.
dc.relation.referencesItskoviz D, Boltin D, Leibovitzh H, et al. Smoking increases the likelihood of Helicobacter pylori treatment failure. Dig Liver Dis. 2017;49(7):764-768
dc.relation.referencesSuzuki T, Matsuo K, Ito H, et al. Smoking increases the treatment failure for Helicobacter pylori eradication. Am J Med. 2006;119(3):217-224
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.subject.proposalH. pylori
dc.subject.proposalHelicobacter pylori
dc.subject.proposalHelicobacter pylori
dc.subject.proposaldual therapy
dc.subject.proposalTerapia dual
dc.subject.proposalterapia dual
dc.subject.proposalinhibidor de bomba de protones
dc.subject.proposalproton pump inhibitor
dc.subject.proposalEficacia
dc.subject.proposalamoxicilina
dc.subject.proposalamoxicillin
dc.type.coarhttp://purl.org/coar/resource_type/c_7a1f
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.contentText
dc.type.redcolhttp://purl.org/redcol/resource_type/TP
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2


Files in this item

Thumbnail
Thumbnail

This item appears in the following Collection(s)

Show simple item record

Atribución-NoComercial-SinDerivadas 4.0 InternacionalThis work is licensed under a Creative Commons Reconocimiento-NoComercial 4.0.This document has been deposited by the author (s) under the following certificate of deposit