Improving Helicobacter pylori eradication regimens

Annals of internal medicine (Impact Factor: 17.81). 02/2006; 144(2):140-1. DOI: 10.7326/0003-4819-144-2-200601170-00013
Source: PubMed
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    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.
    No preview · Article · Sep 2006
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    ABSTRACT: Removal of a woman's ovaries (known as bilateral oophorectomy, ovariectomy or, historically, ovariotomy) is undertaken in a number of countries. An estimated 19,000 women aged <60 years had a bilateral prophylactic oophorectomy in the UK in 2003, either as a planned response to an increased specific genetic risk of ovarian or breast cancer or, more frequently, as a prophylactic measure to prevent ovarian cancer. Despite its popularity, however, a full evaluation of the risks, costs and benefits of prophylactic oophorectomy in the absence of genetic markers and at the time of hysterectomy has not yet been undertaken. This paper seeks to provide a historical perspective on current practice by outlining approaches to the ovary in Britain from the 19th century onwards. Historically, ovarian removal has raised many questions about the costs and benefits of surgery. The aim of this article is to highlight the issues, and in so doing, to contribute to a more informed assessment of current practice.
    Preview · Article · Mar 2007 · Journal of Epidemiology & Community Health
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    ABSTRACT: Standard triple therapies are the most used treatment in clinical practice. However, a critical fall in the H pylori eradication rate following these therapies has been observed in the last few years. The sequential regimen is a novel, promising therapeutic approach. To evaluate the available data on the sequential therapy regimen. A pooled-data analysis of all studies on the sequential regimen was performed. The eradication rate was calculated according to gastroduodenal pathology, proton pump inhibitor used, antibiotic resistance, as well as setting (paediatric or geriatric patients). Compliance, side effects, and cost implications were also evaluated. Overall, more than 1800 patients have been treated with the sequential regimen. Such a therapy was superior to 7-10 days triple therapies in paediatric, adult and elderly patients, achieving an eradication rate constantly higher than 90% at ITT analysis. Although primary clarithromycin resistance reduced the efficacy of such a therapy, a success rate significantly higher than that observed with the standard 7-10 days triple therapies was found. The 10-day sequential treatment regimen achieves higher eradication rates than standard triple therapies.
    Full-text · Article · Nov 2007 · Gut
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