Role of Bismuth in the Eradication of Helicobacter pylori

American Journal of Therapeutics
Huseyin AlkimCanan Alkim

Abstract

Bismuth salts exert their activity within the upper gastrointestinal tract through action of luminal bismuth. Bismuth exerts direct bactericidal effect on Helicobacter pylori by different ways: forms complexes in the bacterial wall and periplasmic space, inhibits different enzymes, ATP synthesis, and adherence of the bacteria to the gastric mucosa. Bismuth also helps ulcer healing by acting as a barrier to the aggressive factors and increasing mucosal protective factors such as prostaglandin, epidermal growth factor, and bicarbonate secretion. To date, no resistance to bismuth has been reported. Also synergism between bismuth salts and antibiotics was present. It was shown that metronidazole and clarithromycin resistant H. pylori strains become susceptible if they are administered together with bismuth. Bismuth-containing quadruple therapy was recommended both by the Second Asia-Pacific Consensus Guidelines and by the Maastricht IV/Florence Consensus Report as an alternative first choice regimen to standard triple therapy, in areas with low clarithromycin resistance, and it is recommended as the first-line therapeutic option in areas with a high prevalence of clarithromycin resistance. Greater than 90% eradication success can b...Continue Reading

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Citations

Sep 12, 2018·Helicobacter·Neil R O'MorainColm A O'Morain
Aug 11, 2019·Pharmacotherapy·Cynthia T NguyenJulius Li
Feb 8, 2020·Nanomedicine·Qianyu ZhangXuefeng Xia
Sep 22, 2020·Future Microbiology·Lyudmila BoyanovaIvan Mitov
Apr 27, 2021·Metallomics : Integrated Biometal Science·Natalie C KorkolaMartin J Stillman

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