Antimicrobial treatment of Helicobacter pylori infection

被引:22
作者
Goodwin, CS
机构
关键词
D O I
10.1086/516078
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Helicobacter pylori is susceptible to many antimicrobials, but clinically only a few are effective. Two antimicrobials with bismuth or ranitidine or a proton pump inhibitor such as omeprazole are required to achieve a cure rate of >90% and to avoid resistance, which occurs when clarithromycin or metronidazole is the single antimicrobial used. Bismuth plus metronidazole and tetracycline is effective but causes more side effects than does treatment with omeprazole, amoxicillin, and clarithromycin; metronidazole can replace clarithromycin. To ensure a high cure rate, treatment is required for 10 days, but 7-day regimens have sometimes been as successful. A course of ranitidine bismuth citrate for 28 days, given with clarithromycin for the first 14 days, cures 80%-85% of patients, but given with amoxicillin it cures only 74%. In developing countries resistance to metronidazole can reach 95%. An inexpensive regimen is bismuth subsalicylate (two tablets) plus furazolidone (100 mg), four times daily for 4 weeks; however, as this yields a cure rate of only 72%, this regimen is not truly cost-effective.
引用
收藏
页码:1023 / 1026
页数:4
相关论文
共 23 条
[1]  
BARDHAN KD, 1995, GASTROENTEROLOGY, V108, pA53, DOI 10.1016/0016-5085(95)22875-6
[2]   RECURRENCE OF DUODENAL-ULCER AND CAMPYLOBACTER-PYLORI INFECTION AFTER ERADICATION [J].
BORODY, TJ ;
COLE, P ;
NOONAN, S ;
MORGAN, A ;
LENNE, J ;
HYLAND, L ;
BRANDL, S ;
BORODY, EG ;
GEORGE, LL .
MEDICAL JOURNAL OF AUSTRALIA, 1989, 151 (08) :431-&
[3]   OMEPRAZOLE ENHANCES EFFICACY OF TRIPLE THERAPY IN ERADICATING HELICOBACTER-PYLORI [J].
BORODY, TJ ;
ANDREWS, P ;
FRACCHIA, G ;
BRANDL, S ;
SHORTIS, NP ;
BAE, H .
GUT, 1995, 37 (04) :477-481
[4]   THE E-TEST FOR ANTIMICROBIAL SUSCEPTIBILITY TESTING OF HELICOBACTER-PYLORI [J].
CEDERBRANT, G ;
KAHLMETER, G ;
LJUNGH, A .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 1993, 31 (01) :65-71
[5]   CLARITHROMYCIN-INDUCED DIGOXIN TOXICITY IN A PATIENT WITH AIDS [J].
FORD, A ;
SMITH, LC ;
BALTCH, AL ;
SMITH, RP .
CLINICAL INFECTIOUS DISEASES, 1995, 21 (04) :1051-1052
[6]  
GLUPCZYNSKI Y, 1990, AM J GASTROENTEROL, V85, P98
[7]  
GLUPCZYNSKI Y, 1987, LANCET, V1, P1096
[8]   PREVENTION OF NITROIMIDAZOLE RESISTANCE IN CAMPYLOBACTER-PYLORI BY COADMINISTRATION OF COLLOIDAL BISMUTH SUBCITRATE - CLINICAL AND INVITRO STUDIES [J].
GOODWIN, CS ;
MARSHALL, BJ ;
BLINCOW, ED ;
WILSON, DH ;
BLACKBOURN, S ;
PHILLIPS, M .
JOURNAL OF CLINICAL PATHOLOGY, 1988, 41 (02) :207-210
[9]  
GOODWIN CS, 1992, HELICOBACTER PYLORI, P224
[10]   TRIPLE THERAPY WITH RANITIDINE, CLARITHROMYCIN, AND METRONIDAZOLE IN THE TREATMENT OF HELICOBACTER-PYLORI [J].
GOTZ, JM ;
VEENENDAAL, RA ;
VESELIC, M ;
BERNARDS, S ;
LAMERS, CBHW .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1995, 30 :34-37