Pharmacological therapy of Helicobacter pylori infection.
Helicobacter pylori has been associated with several diseases including peptic ulcer disease and gastric cancer. Eradication of H pylori not only results in ulcer healing, but reduces recurrences essentially curing peptic ulcer disease. Eradicating H pylori can be difficult. There are several reasons for antimicrobial failure, and the resistance rates for several antibiotics are increasing. The most common drugs used to treat this infection include amoxicillin, clarithromycin, tetracycline, bismuth, and omeprazole and lansoprazole. Dual therapy using a proton pump inhibitor and a single antibiotic gives a suboptimal eradication rate. Triple therapy using at least two antibiotics and either bismuth or a proton pump inhibitor gives satisfactory eradication rates of 90%. However, these regimens are complicated and have significant side effects and compliance problems. The ideal regimen has yet to be developed. In the future, we will prevent infection with immunization. Several vaccines are being developed.
Hoffman
J S
JS
Tufts University School of Medicine, Boston, MA, USA.
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000658:Amoxicillin / Q000494:pharmacology; D000863:Antacids / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000897:Anti-Ulcer Agents / Q000494:pharmacology; D001729:Bismuth / Q000494:pharmacology; D017291:Clarithromycin / Q000494:pharmacology; D016527:Drug Costs; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000494:pharmacology*; D017408:Guidelines as Topic; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D064747:Lansoprazole; D009853:Omeprazole / Q000031:analogs & derivatives / Q000494:pharmacology; D010349:Patient Compliance; D010406:Penicillins / Q000494:pharmacology; D054328:Proton Pump Inhibitors; D013752:Tetracycline / Q000494:pharmacology; D016896:Treatment Outcome; D014611:Vaccination
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000863:Antacids; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D010406:Penicillins; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D000658:Amoxicillin; D013752:Tetracycline; D017291:Clarithromycin; D009853:Omeprazole; D001729:Bismuth