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Volume 3
Microbiology 2019 & Fungal infections 2019
October 07-08, 2019
Journal of Clinical Microbiology and Infectious diseases
October 07-08, 2019 | Madrid, Spain
MICROBIOLOGY AND MICROBIOLOGISTS
MYCOLOGY AND FUNGAL INFECTIONS
2
nd
Annual Congress on
6
th
International Conference on
&
J Clin Microbiol Infect Dis, Volume 3
Single-capsule bismuth-based quadruple therapy as second-line or salvage treatment
for
Helicobacter pylori
infection: A new window of opportunity in a South-European
country?
Catarina Correia
2
, Nuno Almeida
2,3
, Carina Leal
1
, Diogo Branquinho
4
, Alexandra Fernandes
1
, Carlos Calhau
2
,
Isabel Bastos
4
, Luís Tomé
2
and
Helena Vasconcelos
1
1
Centro Hospitalar de Leiria, Portugal
2
Centro Hospitalar e Universitário de Coimbra, Portugal
3
Faculdade de Medicina Da Universidade de Coimbra, Portugal
4
Centro Hospitalar do Baixo Vouga, Portugal
Introduction
:
Helicobacter pylori (H. pylori)
infection is highly prevalent in Portugal and its eradication is formally recommended
in multiple circumstances. However, the indiscriminate use of antimicrobials has led to a drastic rise in antibiotic resistance,
with failure of traditional eradication schemes. Bismuth was not available in this South-European country, but a single-capsule
bismuth-based quadruple treatment became recently available. This study aims to determine whether this quadruple regimen is
useful as a second-line or salvage therapy.
Patients and methods
: This was a multicentric, retrospective study, with most patients included in a prospective database but
without any direct intervention of the investigation team before or during treatment. All consecutive patients that were treated
with bismuth-based quadruple therapy as second-line or salvage treatment between July-2017 and October-2018 were enrolled.
Their medical records were reviewed and clinical and laboratorial parameters, as well as data on treatment efficacy and adverse
events were retrieved. Patients were also contacted by telephone after treatment in order to confirm compliance (considered as
adequate when at least 90% of prescribed medication was taken), adverse events and global satisfaction with this specific therapy.
Results
: A total of 196 subjects were included (female – 65.8%; mean age – 55.13±13.14 years). Patients had previously
completed a mean of 1.12 eradication schemes (0 to 5): triple clarithromycin-based – 33.2%; sequential – 22.4%; concomitant –
7.7%; fluoroquinolone-based – 7.1%; rifabutine-based – 1.0%. The proton pump inhibitor of choice was esomeprazole (42.9%),
followed by omeprazole (24%). Compliance was achieved in 93.9% and the overall eradication rate was 90.8% (95% confidence
interval: 86.7-94.4). Treatment-related adverse effects were experienced by 83 patients (42.3%), being mild in 39, moderate in 30
and severe in 15. The main drawbacks of the treatment in the patient’s perspective were its’ high price (45.9%) and the adverse
effects (16.8%). Failure to eradicate
H. pylori
was correlated with the following: previous rifabutine-base scheme (15.4% vs. 0%)
and higher number of previous treatment regimens (1.94±1.9 vs. 1.03±0.9).
Conclusion
: In this South-European country a single-capsule bismuth-based quadruple therapy is an excellent alternative in
patients who have failed previous eradication schemes, with acceptable compliance and side effects.
Biography
Catarina Correia, born on December 15, 1991 in Coimbra. She completed secondary education at Colegio São Martinho in Coimbra.
She began her master's Degree in Medicine in September 2010 at the School of Health Sciences of the University of Beira Interior
completing the same in 2016. That same year she underwent the National Examination of Seriation, obtaining a classification of 93%
and position at level 101 nacionally. Her common year was at the Hospital Center and University of Coimbra. She chose the specialty
of Gastroenterology in the Department of Gastroenterology of the Hospital and University Center of Coimbra and started the intership
in 2018. She is currently at the beginning of her second year of residency.
catarina-jac@hotmail.com