RevisiónIV Conferencia Española de Consenso sobre el tratamiento de la infección por Helicobacter pyloriIV Spanish Consensus Conference on Helicobacter pylori infection treatment
Section snippets
Introducción
La infección por Helicobacter pylori afecta a alrededor del 50% de la población mundial y desempeña un papel fundamental en el desarrollo de diversas enfermedades digestivas como la gastritis crónica, la úlcera péptica y el cáncer gástrico, por lo que un diagnóstico adecuado y un tratamiento eficaz son esenciales en la práctica clínica. Se han organizado hasta el momento diversas Conferencias de Consenso sobre el diagnóstico y tratamiento de la infección por este microorganismo en América,
Metodología
Participantes en el Consenso. Se invitó a todos los expertos que participaron en la última Conferencia de Consenso celebrada en 20123. Además, se identificó (mediante la estrategia de búsqueda «helicobacter pylori AND Spain» en PubMed) e invitó a los investigadores que durante los últimos 4 años hubieran publicado como primer autor algún artículo sobre el tratamiento de la infección por H. pylori. En total, 19 expertos fueron invitados, de los que finalmente participaron 18 (95%), incluyendo
Recomendaciones
Cada recomendación se acompaña del resultado de la votación (porcentaje de acuerdo), el grado de recomendación (GR; fuerte o débil), la calidad de la evidencia (CE; alta, moderada, baja o muy baja) y de la discusión de la evidencia correspondiente.
Todas las recomendaciones aprobadas en el presente Consenso Español sobre el tratamiento de la infección por H. pylori se incluyen en la tabla 1. Los fármacos, la duración y la dosis de cada uno de los componentes de las pautas recomendadas se
Conflicto de intereses de los participantes en la IV Conferencia Española de Consenso sobre el tratamiento de la infección de Helicobacter pylori
Javier P. Gisbert: asesoramiento científico, soporte para investigación y actividades formativas: Almirall, Allergan, AstraZeneca, Casen Recordati, Nycomed.
Javier Molina-Infante: asesoramiento científico: Casen Recordati; actividades formativas: Allergan, Zambón.
Javier Amador: ninguno.
Fernando Bermejo: ninguno.
Luis Bujanda: ninguno.
Xavier Calvet: actividades formativas: Allergan.
Manuel Castro-Fernández: actividades formativas: Allergan.
Antonio Cuadrado: ninguno.
J. Ignasi Elizalde: ninguno.
Emili
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First-line eradication rates comparing two shortened non-bismuth quadruple regimens against Helicobacter pylori: An open-label, randomized, multicentre clinical trial
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Clarithromycin for first-line treatment of Helicobacter pylori infection after culture in high-resistance regions
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Optimised empiric triple and concomitant therapy for Helicobacter pylori eradication in clinical practice: The OPTRICON study
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Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption
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Prevalence of primary resistance of Helicobacter pylori to clarithromycin and levofloxacin in Southern Spain
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Nonbismuth quadruple (concomitant) therapy: Empirical and tailored efficacy versus standard triple therapy for clarithromycin-susceptible Helicobacter pylori and versus sequential therapy for clarithromycin-resistant strains
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Optimized nonbismuth quadruple therapies cure most patients with Helicobacter pylori infection in populations with high rates of antibiotic resistance
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Randomised clinical trial comparing sequential and concomitant therapies for Helicobacter pylori eradication in routine clinical practice
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Non bismuth quadruple ‘concomitant’ therapies in the eradication of Helicobacter pylori: Standard vs. optimized (14 days, high-dose PPI) regimens in clinical practice
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Concomitant versus sequential therapy for the treatment of Helicobacter pylori infection: A Greek randomized prospective study
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A randomised study comparing 10 days concomitant and sequential treatments for the eradication of Helicobacter pylori, in a high clarithromycin resistance area
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Clinical evaluation of a ten-day regimen with esomeprazole, metronidazole, amoxicillin, and clarithromycin for the eradication of Helicobacter pylori in a high clarithromycin resistance area
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Sequential, concomitant and hybrid first-line therapies for Helicobacter pylori eradication: A prospective randomized study
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Sequential and concomitant therapy with four drugs is equally effective for eradication of H. pylori infection
Clin Gastroenterol Hepatol.
Randomized controlled trial comparing 7-day triple, 10-day sequential, and 7-day concomitant therapies for Helicobacter pylori infection
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Non-bismuth quadruple therapy for first-line Helicobacter pylori eradication: A randomized study in Japan
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A new modified concomitant therapy for Helicobacter pylori eradication in Turkey
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Clinical outcomes of two-week sequential and concomitant therapies for Helicobacter pylori eradication: A randomized pilot study
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2022, Gastroenterologia y HepatologiaCurrent trends and future perspectives of probiotics on human health: an overview
2022, Recent Advances and Future Perspectives of Microbial Metabolites: Applications in BiomedicineAntibiotic resistances and eradication rates in Helicobacter pylori infection
2021, Anales de PediatriaGastric cancer screening in low incidence populations: Position statement of AEG, SEED and SEAP
2021, Gastroenterologia y HepatologiaProspective comparative study between two first-line regimens for Helicobacter pylori eradication: Non-bismuth quadruple versus bismuth quadruple therapy
2020, Gastroenterologia y HepatologiaCitation Excerpt :Two subsequent review articles and a recent meta-analysis showed very high resistance rates in countries such as Spain (17.6–51.2%), Italy (72.4%), Poland (9.0–55.2%) France (43%) and Ireland (51.9%).15–17 In this setting it has been documented that the combinations described in Maastricht V guideline achieve in clinical trials and meta-analysis an efficacy over 90%.18–20 Nevertheless, it is also known that treatment compliance affected the eradication rate, and it is a constant that the adherence to treatment achieved in a clinical trial substantially exceeds that observed in clinical practice.
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Ambos autores han contribuido por igual al consenso.