Clinical Practice Guidelines of Russian Gastroenterological Association, Scientific Society for the Clinical Study of Human Microbiome, Russian Society for the Prevention of Non-Communicable Diseases, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy for H. pylori Diagnostics and Treatment in Adults
V. T. Ivashkin,
T. L. Lapina,
I. V. Maev,
O. M. Drapkina,
R. S. Kozlov,
A. A. Sheptulin,
A. S. Trukhmanov,
S. R. Abdulkhakov,
O. P. Alekseeva,
S. A. Alekseenko,
D. N. Andreev,
D. S. Bordin,
N. N. Dekhnich,
I. L. Klyaritskaya,
N. V. Korochanskaya,
M. F. Osipenko,
E. A. Poluektova,
A. S. Sarsenbaeva,
V. I. Simanenkov,
A. V. Tkachev,
A. I. Ulyanin,
I. B. Khlynov,
V. V. Tsukanov https://doi.org/10.22416/1382-4376-2022-32-6-72-93
Abstract
Aim: bring to the attention of practitioners indications for anti-Helicobacter therapy, methods and procedure for diagnostics and eradication therapy of Н. pylori infection.
Key points. Chronic gastritis caused by Н. pylori infection, including asymptomatic persons, may be considered as an indication for eradication therapy of Н. pylori as etiological therapy and opportunistic screening for gastric cancer prevention. Indications, for obligatory anti-Helicobacter therapy include peptic ulcer, gastric MALT lymphoma, early gastric cancer (EGC) with endoscopic resection. H. pylori primary diagnostics methods include 13C-urea breath test, H. pylori stool antigen lab test, rapid urease test and serological method. The serological method cannot be used after anti-Helicobacter therapy.
In Russia H. pylori strains' resistance to clarithromycin does not exceed 15 % in most regional studies. The first line therapy for Н. pylori infection eradication is the standard triple therapy including a proton pump inhibitor (PPI), clarithromycin and amoxicillin, enhanced with bismuthate tripotassium dicitrate. A classic four-component therapy based on bismuthate tripotassium dicitrate or quadrotherapy without bismuth drug products which includes PPI, amoxicillin, clarithromycin and metronidazole, may be used as alternative to the first line eradication therapy. The standard triple therapy may be prescribed for 14 days only in those regions, where it has been proven to be effective. Quadrotherapy with bismuthate tripotassium dicitrate is also used as main second line therapy in case of standard triple therapy, bismuth enhanced standard triple therapy or combined therapy failure. Another second line therapy includes PPI, levofloxacin and amoxicillin, to which a bismuth-containing drug product may be added. The third line therapy is selected individually based on previously used treatment settings.
Conclusion. In each case of H. pylori infection the decision for eradication therapy should be made, which is especially relevant as eradication of H. pylori has been recognized as an effective measure for the prevention of gastric cancer.
About the Authors
V. T. Ivashkin
Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Vladimir T. Ivashkin — Dr. Sci. (Med.), RAS Academician, Prof., Departmental Head, Department of Propaedeutics of Internal Diseases, N.V. Chief of Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).
119435, Moscow, Pogodinskaya str., 1 bld. 1
T. L. Lapina
Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Tatyana L. Lapina — Cand. Sci. (Med.), Assoc.Prof., Chair of Internal Disease Propaedeutics, Gastroenterology and Hepatology, I.M. Sechenov First Moscow State Medical University (Sechenov University).
119435, Moscow, Pogodinskaya str., 1, bld. 1
I. V. Maev
Endocrinology Research Centre
Russian Federation
Russian Federation
Igor V. Maev — RAS Academician, Dr. Sci. (Med.), Prof., Departmental Head, Department of Internal Disease Propaedeutics and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry.
127473, Moscow, Delegatskaya str., 20, blg. 1
O. M. Drapkina
National Research Center for Preventive Medicine
Russian Federation
Russian Federation
Oksana M. Drapkina — Dr. Sci. (Med.), RAS Academician, Director of FSBI National medical research center of preventive medicine of the Russian Ministry of Health.
101000, Moscow, Petroverginskiy lane, 10, bld. 3
R. S. Kozlov
Smolensk State Medical University
Russian Federation
Russian Federation
Roman S. Kozlov — Dr. Sci. (Med.), Prof., Corresponding Member of Russian Academy of Sciences (RAS), rector, Smolensk State Medical University, director, Research Institute of Antimicrobial Chemotherapy, President of the Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy (IACMAC).
214019, Smolensk, Krupskoy str., 28
A. A. Sheptulin
Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Arkadiy A. Sheptulin — Dr. Sci. (Med.), Prof., Chair of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University).
119435, Moscow, Pogodinskaya str., 1, bld. 1
A. S. Trukhmanov
Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Aleksandr S. Trukhmanov — Dr. Sci. (Med.), Prof., Department of Internal Disease Propaedeutics, Sechenov First Moscow State Medical University (Sechenov University).
119435, Moscow, Pogodinskaya str., 1, bld. 1
S. R. Abdulkhakov
Kazan Federal University; Kazan State Medical University
Russian Federation
Russian Federation
Sayar R. Abdulkhakov — Cand. Sci. (Med.), Head of the Chair of Internal Diseases, Institute of Fundamental Medicine and Biology, Kazan Federal University, Assoc. Prof., Department (Chair) of Outpatient Therapy and General Medical Practice, Kazan State Medical University.
420012, Kazan, Kremlyovskaya str., 18
O. P. Alekseeva
Privolzhsky Research Medical University
Russian Federation
Russian Federation
Olga P. Alekseeva — Dr. Sci. (Med.), Prof., Chair of Hospital Therapy and General Practice named after V.G. Vogralik, Privolzhsky Research Medical University.
603005, Nizhny Novgorod, Minina i Pozharskogo sq., 10/1
S. A. Alekseenko
Far-Eastern State Medical University
Russian Federation
Russian Federation
Sergey A. Alekseenko — Dr. Sci. (Med.), Head of the Department of Hospital Therapy, Far-Eastern State Medical University.
680000, Khabarovsk, str. Muravyov-Amurskogo, 35
D. N. Andreev
Endocrinology Research Centre
Russian Federation
Russian Federation
Dmitry N. Andreev — Cand. Sci. (Med.), Assoc. Prof., Department of Propaedeutics of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry.
127473, Moscow, Delegatskaya str., 20, bld. 1
D. S. Bordin
Endocrinology Research Centre; Loginov Moscow Clinical Scientific Center; Tver State Medical University
Russian Federation
Russian Federation
Dmitry S. Bordin — Dr. Sci. (Med.), Head of the Department of Pancreatic, Bile and Upper Gastrointestinal Pathology, Loginov Moscow Clinical Scientific Center; Prof., Department of Internal Medicine Propaedeutics and Gastroenterology, Moscow State University of Medicine and Dentistry; Prof., Department of general medical practice and family medicine, Tver State Medical University.
111123, Moscow, Entuziastov highway, 86, bld. 6
N. N. Dekhnich
Smolensk State Medical University
Russian Federation
Russian Federation
Natalya N. Dekhnich — Dr. Sci. (Med.), Prof., Department of Faculty Therapy; Smolensk State Medical University.
214019, Smolensk, Krupskaya str., 28
I. L. Klyaritskaya
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Irina L. Klyaritskaya — Dr. Sci. (Med.), Prof., Head of the Department of Therapy, Gastroenterology, Cardiology and General Practice (Family Medicine), Medical Academy named after S.I. Georgievsky, Vernadsky Crimean Federal University.
295017, Republic of Crimea, Simferopol, Lenina blvd, 5/7
N. V. Korochanskaya
Kuban State Medical University
Russian Federation
Russian Federation
Natalia V. Korochanskaya — Dr. Sci. (Med.), Head of the Gastroenterology Centre, Prof., Chair of Surgery No. 3, Kuban State Medical University; Chief Gastroenterologist of the Ministry of Health of the Krasnodar Territory.
350063, Krasnodar, Mitrofana Sedina str., 4
M. F. Osipenko
Novosibirsk State Medical University
Russian Federation
Russian Federation
Marina F. Osipenko — Dr. Sci. (Med.), Prof., Head of the Chair of Internal Diseases Propedeutics, Novosibirsk State Medical University.
630091, Novosibirsk, Krasnyi ave., 52
E. A. Poluektova
Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Elena A. Poluektova — Dr. Sci. (Med.), Prof., Chair of Internal Disease Propaedeutics, Gastroenterology and Hepatology; Gastroenterologist, Department of Chronic Intestinal and Pancreatic Diseases, Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology Sechenov First Moscow State Medical University (Sechenov University).
119435, Moscow, Pogodinskaya str., 1, bld. 1
A. S. Sarsenbaeva
South Ural State Medical University
Russian Federation
Russian Federation
Aiman S. Sarsenbaeva — Dr. Sci. (Med.), Prof. of the Department of Therapy, Dean of Institute of Additional Professional Education, South Ural State Medical University. Contact information: aiman-ss@yandex.ru;
454092, Chelyabinsk, Vorovskogo str., 64
V. I. Simanenkov
Mechnikov North-Western State Medical University
Russian Federation
Russian Federation
Vladimir I. Simanenkov — Dr. Sci. (Med.), Prof., Chair of Internal Diseases, Clinical Pharmacology and Nephrology, I.I. Mechnikov North-West State Medical University.
191015, St.-Petersburg, Kirochnaya str., 41
A. V. Tkachev
Rostov State Medical University
Russian Federation
Russian Federation
Aleksandr V. Tkachev — Doc. Sci. (Med.), Prof., Departmental Head, Department of Internal Diseases Propaedeutics, Rostov State Medical University.
344022, Rostov-on-Don, Nakhichevansky per., 29
A. I. Ulyanin
Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Anatoly I. Ulyanin — Gastroenterologist, Department of Chronic Intestinal and Pancreatic Diseases, Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).
119435, Moscow, Pogodinskaya str., 1, bld. 1
I. B. Khlynov
Ural State Medical University
Russian Federation
Russian Federation
Igor B. Khlynov — Dr. Sci. (Med.), Assoc. Prof., Chair of Intermediate Therapy and Geriatrics, Ural State Medical University.
620028, Ekaterinburg, Repina str., 3
V. V. Tsukanov
Research Institute for Medical Problems in the North - Division of Krasnoyarsk Scientific Centre of Siberian Branch of the RAS
Russian Federation
Russian Federation
Vladislav V. Tsukanov — Dr. Sci. (Med.), Prof., Head of the Clinical Department of Adult and Infant Digestive Pathology, Research Institute for Medical Problems in the North — Division of Krasnoyarsk Scientific Centre of the Siberian Branch of the RAS.
660022, Krasnoyarsk, Partizana Zheleznyaka str., 3Г
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Ivashkin V.T., Lapina T.L., Maev I.V., Drapkina O.M., Kozlov R.S., Sheptulin A.A., Trukhmanov A.S., Abdulkhakov S.R., Alekseeva O.P., Alekseenko S.A., Andreev D.N., Bordin D.S., Dekhnich N.N., Klyaritskaya I.L., Korochanskaya N.V., Osipenko M.F., Poluektova E.A., Sarsenbaeva A.S., Simanenkov V.I., Tkachev A.V., Ulyanin A.I., Khlynov I.B., Tsukanov V.V. Clinical Practice Guidelines of Russian Gastroenterological Association, Scientific Society for the Clinical Study of Human Microbiome, Russian Society for the Prevention of Non-Communicable Diseases, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy for H. pylori Diagnostics and Treatment in Adults. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2022;32(6):72-93. https://doi.org/10.22416/1382-4376-2022-32-6-72-93
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