Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan.
Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan.
Curr Rev Clin Exp Pharmacol. 2021;16(2):128-138. doi: 10.2174/1574884715666200702121417.
Helicobacter pylori (H. pylori) infection is the most common cause of peptic ulcer disease and it can be associated with many complications, including malignancies. In clinical practice, some clinicians may use Clavulanic Acid (CA) in combination with amoxicillin or other beta-lactams as an addition to the standard treatment regimens. This practice may be done by habitual mistake, non-evidence based hypothetical assumptions, or by prescribing it as an alternative treatment. This review aims to expose the effect of CA against H. pylori infection and to review the possible mechanisms that may contribute to that effect.
A PubMed and Google Scholar literature search was obtained on both pre-clinical and clinical studies related to CA and H. pylori infection.
Available clinical studies showed improvement in the eradication of H. pylori by about 10- 20% when CA was added to the treatment regimens. This effect for CA could be related to several mechanisms including inhibition of H. pylori growth by binding to Penicillin-Binding Proteins (PBPs), the transformation of H. pylori from the active filamentous form into coccoidal form, induction of the release of dopamine, modulation of immunological response towards H. pylori infection and its relationship with other microbiota. Randomized-controlled studies on patients with resistance to H. pylori are needed. Moreover, in vitro studies to evaluate the mechanisms by which CA may influence H. pylori are warranted.
The presented literature suggests potential avenues for the use of CA in the management of peptic ulcer disease and H. pylori infection.
幽门螺杆菌（H. pylori）感染是消化性溃疡病最常见的病因，它可能与许多并发症相关，包括恶性肿瘤。在临床实践中，一些临床医生可能会将克拉维酸（CA）与阿莫西林或其他β-内酰胺类药物联合使用，作为标准治疗方案的补充。这种做法可能是习惯性错误、基于假设的非证据性做法，或者是将其作为替代治疗方法。本综述旨在探讨 CA 对 H. pylori 感染的作用，并综述可能有助于这种作用的潜在机制。
对与 CA 和 H. pylori 感染相关的临床前和临床研究进行了 PubMed 和 Google Scholar 文献检索。
现有临床研究表明，当 CA 添加到治疗方案中时，H. pylori 的根除率可提高约 10-20%。CA 的这种作用可能与几种机制有关，包括与青霉素结合蛋白（PBPs）结合抑制 H. pylori 的生长、将 H. pylori 从活性丝状形式转变为球菌形式、诱导多巴胺释放、调节针对 H. pylori 感染的免疫反应及其与其他微生物群的关系。需要针对 H. pylori 耐药患者进行随机对照研究。此外，还需要进行体外研究以评估 CA 影响 H. pylori 的机制。
现有文献提示 CA 在治疗消化性溃疡病和 H. pylori 感染方面具有潜在的应用途径。
