[The role and significance of acid suppressive drugs in the eradication of H. pylori].
Recently a new triple therapy with PPI and two antimicrobials is widely accepted instead of classical triple therapy. PPI has direct and indirect effects on H. pylori. Practically a single use of PPI is almost noneffective for eradication of H. pylori. In the combination therapy PPI is supposed to contribute to successful eradication through the inhibition of acid secretion. Because a raise of pH in stomach protects antimicrobials from the degradation by acidic environment. The decrease in the volume of gastric juice also contributes to concentrate antibiotics. Recently interaction between PPI and clarithromycin on metabolic enzyme in liver was reported that explains the synergistic effects of these drugs. The heterogeneity of genotype of metabolic enzyme was also elucidated which might be responsible for the difference in the effect of PPI between the patients. To accomplish successful eradication, full inhibition of acid secretion has to be done. To consider the interactions between PPI and antimicrobials and the heterogeneity of genotype of metabolic enzyme may improve eradication therapy of H. pylori.
3rd Department of Internal Medicine, Teikyo University Ichihara Hospital.
K
K
Yakabi
K
K
Tsuda
K
K
Ogawa
Y
Y
Hoshika
H
H
Tomono
T
T
Nakamura
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003864:Depression, Chemical; D004359:Drug Therapy, Combination; D005744:Gastric Acid / Q000378:metabolism; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D009853:Omeprazole / Q000494:pharmacology / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D009853:Omeprazole