The May issue of The American Journal of GASTROENTEROLOGY is completely devoted to negative research results and https://pillintrip.com/de/medicine/diprospan. These are simply unreal 😱 things (for Russian science, so for sure).
And I will review several of the articles in this issue.
🔥 Everyone’s favorite topic is the development of antibiotic-associated diarrhea after H. pylori therapy.
✔️ There are descriptions, but no large studies have been carried out.
✔️Everyone is expected, because HP eradication includes at least 2 antibiotics, and even for 10-14 days.
However, look at the data from a retrospective cohort study (1994-2018) that included ❗️38,535 patients with detected ADR:
– 91.8% are men (Americans also like to do science for the military);
– the average age is 61.8 years;
– positive test for Clostridium difficile (it is this bacterium that causes antibiotic-associated diarrhea – CDI) within 3 months after detection of HP;
💡78.4% passed HP eradication;
💡Antibiotics used in HP eradication regimens – see carousel.
❗️ Only 0.74% had CDI.
Multivariate analysis showed the most significant relationship between CDI and:
❗️ a history of CDI;
❗️ and recent hospitalization (within 4 and 12 weeks).
❌HR therapy was not associated with CDI, although there was a weak association with successful eradication performed.
By the way, a weak connection was also found with smoking.
But additional results are interesting:
Those who developed CDI were less likely to take amoxicillin or clarithromycin regimen, but no such data were available for metronidazole and levofloxacin.
“PPI selection was also not associated with CDI (assess which is the most commonly prescribed PPI”).
On the basis of these data, the authors propose to think about whether it is necessary to carry out eradication for a patient who has been hospitalized (or was recently), but, fortunately, do not make it into the recommendations.
The authors also write about the restrictions:
✔️This is still a retrospective study.
✔️ Information from the largest database was evaluated, but it is possible that it is incomplete.
✔️No information about # PPI therapy outside the course of eradication.
And from myself I will note:
❗️ The percentage of compliance to the eradication scheme is not indicated, and the Clostridium difficile test included not only the determination of toxins, but also the PCR method.