The fourth Mexican consensus on Helicobacter pylori
Rev Gastroenterol Mex (Engl Ed). 2018 Jul-Sep;83(3):325-341.
doi: 10.1016/j.rgmx.2018.05.003.
Epub 2018 Jun 22.
[Article in
English,
Spanish]
Authors
F J Bosques-Padilla
1
, J M Remes-Troche
2
, M S González-Huezo
3
, G Pérez-Pérez
4
, J Torres-López
5
, J M Abdo-Francis
6
, M V Bielsa-Fernandez
7
, M C Camargo
8
, F Esquivel-Ayanegui
9
, E Garza-González
10
, A I Hernández-Guerrero
11
, R Herrera-Goepfert
12
, F M Huerta-Iga
13
, Y Leal-Herrera
14
, A Lopéz-Colombo
15
, N X Ortiz-Olvera
16
, A Riquelme-Pérez
17
, C L Sampieri
18
, L F Uscanga-Domínguez
19
, J A Velarde-Ruiz Velasco
20
Affiliations
- 1 Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México. Electronic address: fbosques58@hotmail.com.
- 2 Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Medico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, México.
- 3 Centro Médico ISSEMYM, Metepec, Estado de México, México.
- 4 Escuela de Medicina de la Universidad de Nueva York, New York, N.Y, Estados Unidos.
- 5 UMAE Hospital de Pediatría Dr. Silvestre Frenck Freud, CMN Siglo XXI, IMSS, Ciudad de México, México.
- 6 Hospital Ángeles Acoxpa, Ciudad de México, México.
- 7 Hospital de Atención Médica Ambulatoria de la UAG, Guadalajara, Jalisco, México.
- 8 División de Epidemiología y Genética del Cáncer y, Instituto Nacional de Cáncer, ockville, Maryland, Estados Unidos.
- 9 Hospital General Miguel Silva, Morelia, Michoacán, México.
- 10 Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
- 11 Departamento de Endoscopia, Instituto Nacional de Cancerología, Ciudad de México, México.
- 12 Departamento de Patología, Instituto Nacional de Cancerología, Ciudad de México, México.
- 13 Hospital Ángeles Torreón, Torreón, Coahuila, México.
- 14 Unidad de Investigación Médica Yucatán (UIMY) de la Unidad Médica de Alta Especialidad de Mérida del Instituto Mexicano del Seguro Social (IMSS), Mérida, Yucatán, México.
- 15 Dirección de Educación e Investigación en Salud, UMAE Hospital de Especialidades del Centro Médico Nacional Manuel Ávila Camacho, IMSS, Puebla, Puebla, México.
- 16 Hospital de Especialidades Dr. Bernardo Sepúlveda", CMN Siglo XXI, IMSS, Ciudad de México, México.
- 17 Departamento de Ciencias de la Salud, Facultad de Medicina Pontificia Universidad Católica de Chile, Santiago, Chile.
- 18 Instituto de Salud Pública, Universidad Veracruzana, Xalapa, Veracruz, México.
- 19 Departamento de Gastroenterología y Laboratorio de Motilidad Gastrointestinal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
- 20 Hospital Civil de Guadalajara, Guadalajara, Jalisco, México.
Abstract
Important advances have been made since the last Mexican consensus on the diagnosis and treatment of Helicobacter pylori (H. pylori) infection was published in 2007. Therefore, the Asociación Mexicana de Gastroenterología summoned 20 experts to produce "The Fourth Mexican Consensus on Helicobacter pylori". From February to June 2017, 4 working groups were organized, a literature review was performed, and 3 voting rounds were carried out, resulting in the formulation of 32 statements for discussion and consensus. From the ensuing recommendations, it was striking that Mexico is a country with an intermediate-to-low risk for gastric cancer, despite having a high prevalence of H. pylori infection. It was also corroborated that peptic ulcer disease, premalignant lesions, and histories of gastric cancer and mucosa-associated lymphoid tissue lymphoma should be considered clear indications for eradication. The relation of H. pylori to dyspeptic symptoms continues to be controversial. Eradication triple therapy with amoxicillin, clarithromycin, and a proton pump inhibitor should no longer be considered first-line treatment, with the following 2 options proposed to take its place: quadruple therapy with bismuth (proton pump inhibitor, bismuth subcitrate, tetracycline, and metronidazole) and quadruple therapy without bismuth (proton pump inhibitor, amoxicillin, clarithromycin, and metronidazole). The need for antimicrobial sensitivity testing when 2 eradication treatments have failed was also established. Finally, the promotion of educational campaigns on the diagnosis and treatment of H. pylori for both primary care physicians and the general population were proposed.
Keywords:
Cáncer gástrico; Epidemiology; Epidemiología; Eradication; Erradicación; Gastric cancer; Helicobacter pylori; Mexico; México.
Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.
MeSH terms
-
Anti-Bacterial Agents / therapeutic use
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Drug Therapy, Combination
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Health Education
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Helicobacter Infections / drug therapy*
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Helicobacter Infections / microbiology
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Helicobacter pylori*
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Humans
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Mexico
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Physicians, Primary Care