Improving Helicobacter pylori eradication regimens.

Annals of internal medicine (Impact Factor: 16.1). 02/2006; 144(2):140-1. DOI: 10.7326/0003-4819-144-2-200601170-00013
Source: PubMed
1 Bookmark
  • [Show abstract] [Hide abstract]
    ABSTRACT: Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include H. Pylori, current treatment and emerging therapy. Only articles in English were included. There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure. Primary resistance to clarithromycin or metronidazole significantly affects the efficacy of eradication therapy. This has led to the introduction of second line, third line "rescue," and sequential therapies for resistant cases. Subsequently, new antibiotic combinations with proton-pump inhibitors and bismuth salts are being studied in the last decade, to find out the antibiotics that are capable of increasing the eradication rates. Some of these antibiotics include Levofloxacin, Doxycycline, Rifaximin, Rifampicin, Furazolidone based therapies. Studies are ongoing to determine the efficacy of Lactoferrin based therapy.
    Journal of the Nigeria Medical Association 01/2013; 54(1):1-4.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Zoals inmiddels bekend, neemt de Helicobacter pylori (H. pylori)-resistentie tegen claritromycine wereldwijd toe. De veelgebruikte tripeltherapie voor eradicatie is hierdoor in de Westerse wereld nog maar in 18-44% van de gevallen succesvol. Genetische mutaties (waaronder A2143G, A2142G, A2142C) blijken deze resistentie van de bacterie tegen claritromycine te verklaren.
    Medisch-Farmaceutische Mededelingen. 09/2006; 44(9):251-252.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Helicobacter pylori is the cause of peptic ulcer, gastric cancer and gastric lymphoma. Diagnosis of H. pylori infection can be made using invasive and noninvasive tests. Invasive tests based on endoscopy, such as histology, are recommended when a gastric malignancy is suspected. Alternatively, noninvasive tests, such as the urea breath test and stool tests are useful for H. pylori diagnosis and follow-up. Triple therapy with either amoxicillin or metronidazole, clarithromycin and proton pump inhibitor given twice daily for 7-14 days is the recommended first-line treatment, after having checked the individual clarithromycin antimicrobial susceptibility. A triple therapy with levofloxacin, amoxicillin and proton pump inhibitor for 10-14 days should be used as second-line treatment, where the strains are susceptible to fluoroquinolone. Alternatively, bismuth-based quadruple therapy is recommended.
    Expert Review of Anticancer Therapy 08/2010; 8(8):887-92. · 3.22 Impact Factor