The treatment of Helicobacter pylori infection.
Indications for eradication of Helicobacter pylori infection have widened since the National Institutes of Health consensus conference in 1994. It is argued that they should now include infected patients with non-ulcer dyspepsia, those concerned about the risk of gastric cancer, patients with gastric lymphoma, and those requiring long-term treatment with a proton pump inhibitor. Problems with existing clinical trials are discussed, and the results of different treatment regimens are discussed. It is proposed that future eradication trials should investigate H. pylori-infected subjects identified by serology, rather than ulcer patients, and that eradication is proved only by a pair of 13C-urea breath tests.
Pounder
R E
RE
University Department of Medicine, Royal Free Hospital School of Medicine, London, UK.
Williams
M P
MP
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001729:Bismuth / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy; D054328:Proton Pump Inhibitors; D011899:Ranitidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000517:prevention & control
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; C073340:ranitidine bismuth citrate; D011899:Ranitidine; D001729:Bismuth