Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This randomised double blind placebo controlled study evaluated the effectiveness of colloidal bismuth subcitrate (CBS), ampicillin and their combination in the treatment of Helicobacter Pylori in non-ulcer dyspepsia (NUD) and assessed if elimination of this organism is associated with improvement of gastritis and the symptoms. Forty-eight NUD patients with H. pylori and histologic gastritis were randomly allocated to one of the three regimens for 28 days. Symptoms were assessed before and after treatment. Forty-three patients completed the trial. Repeat endoscopy within 48 hours of completing treatment showed suppression of H. pylori in 6 of 7 patients (85.7%) on combined therapy and one of 8 patients (12.5%) on CBS therapy (p = 0.0205). There was no suppression of the bacteria in patients treated with ampicillin. Repeat endoscopy performed 2 weeks after completing treatment showed suppression of H. pylori in 3 of 7 patients (42.9%) on combined therapy and none in the other two groups. Patients on combined therapy who had suppression of H. pylori, 48 hours or 2 weeks after completing treatment were noted to have historical improvement of their gastritis (p = 0.0001 and p = 0.05 respectively). This was also associated with improvement of symptoms in these patients.
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PMID:Evaluation of therapies in the treatment of Helicobacter pylori associated non-ulcer dyspepsia. 826 68

This study was conducted to evaluate the efficacy and safety of intravenous sulbactam/ampicillin followed by oral sultamicillin. Parenteral sulbactam/ampicillin was administered for 7 to 14 days to 152 in-patients with moderate to severe infections. All patients were treated with sulbactam/ampicillin, but only 140 patients received oral sultamicillin therapy. Eighty-nine men and 63 women participated in this study. Infections included intraabdominal (42 cases), respiratory tract (52 cases), skin and soft tissue (29 cases), urinary tract (16 cases), and miscellaneous infections (14 cases) that included typhoid fever, gastroenteritis, septicemia, and surgical wound infection. Six (4%) patients reported six study drug-related adverse experiences. Gastrointestinal side effects were most common and included epigastric burning and indigestion. Diarrhea was not reported and no patient discontinued drug therapy because of an adverse event. Laboratory abnormalities were infrequent and clinically insignificant. Overall, 98% of the 114 evaluable patients achieved clinical cure or improvement following treatment with sulbactam/ampicillin and sultamicillin. Cured or improved patients in each diagnostic group were 97% for intraabdominal infections, 100% for respiratory tract infections, 100% for skin and soft tissue infections, 100% for urinary tract infection, and 91% for other types of infections. Only 2 (2%) patients were judged to be treatment failures. Microbiologic efficacy, or eradication, was 86% overall, ranging from 75 to 100%. Persistence of pathogens occurred in 5%, and eradication with development of a superinfection occurred in 4%. Fifty-seven percent (30/50) of the isolates tested were resistant to ampicillin alone whereas only 21% (9/42) were resistant to sulbactam/ampicillin (p = 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sulbactam/ampicillin followed by oral treatment with sultamicillin for medical and surgical infections. 268 17

Helicobacter pylori infection is clinically associated with dyspepsia, gastric and duodenal ulcers, and gastric cancer. Increasing antimicrobial resistance in H. pylori is a worldwide problem and failure of eradication with standard triple therapy (high-dose proton pump inhibition, amoxicillin and clarithromycin) is directly related to the presence of a resistant strain. Other treatment combinations have been investigated, but with inconsistent results. Based on a review of the recent literature in conjunction with an analysis of the regional resistance data, we address the increasing complexity of H. pylori eradication therapy. Culture and susceptibility results of all first H. pylori isolates of adults (> 18 years) seen in the Leiden University Medical Center, from January 2006 to December 2015, were analysed (n = 707). An increase in clarithromycin resistance was observed from 9.8% to 18.1% (p = 0.002) in the periods from 2006-2010 and 2011-2015, respectively. For ampicillin the resistance increased from 6.3% to 10.0% (p = 0.37), and for metronidazole from 20.7% to 23.2% (p = 0.42). The tetracycline resistance remained low at 3.2% and 2.3%, respectively. The treatment paradigm is shifting towards individualised treatment rather than a one-strategy-fits-all approach. In case of treatment failure it should be strongly considered to refer a patient for endoscopy, biopsy and culture. Thereafter, targeted antimicrobial treatment based on susceptibility results can be initiated. Furthermore, accumulating data indicate that prolongation of treatment to 14 days, as opposed to the current standard 7 day course, contributes to a higher H. pylori eradication rate.
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PMID:Helicobacter pylori resistance in the Netherlands: a growing problem? 2921 12