My approach to Helicobacter pylori eradication.
The eradication of Helicobacter pylori is advantageous in many diseases of the upper gastrointestinal tract and can result in the cure of conditions such as peptic ulcer disease. It may also potentially prevent the development of gastric cancer. Complete eradication of H. pylori can be difficult to achieve, and the effectiveness of many combinations of agents has been tested in clinical trials over the years. No agent has been found to be effective at eradicating H. pylori when given alone and this has resulted in the development of combination therapies comprising an antisecretory agent and one or more antibiotics. Bismuth-based triple therapies, while considered for years as the 'gold standard', have limited efficacy and may be associated with significant side effects. Dual therapies, comprising a proton pump inhibitor (PPI) and one antibiotic, marked a milestone in the history of H. pylori eradication therapy but have shown inconsistent results and eradication rates of less than 60%. However, these have provided the basis for the development of short-term, low-dose PPI triple therapies, including two antibiotics from among metronidazole, clarithromycin and amoxycillin plus a PPI that have demonstrated excellent eradication rates approaching 100%.
Bazzoli
F
F
Dipartimento di Medicina Interna e Gastroenterologia, Universita degli Studi di Bologna, Italy.
D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D017291:Clarithromycin / Q000008:administration & dosage; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage; D010406:Penicillins / Q000008:administration & dosage; D054328:Proton Pump Inhibitors
D000900:Anti-Bacterial Agents; D010406:Penicillins; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin