[Treatment of Helicobacter pylori infection. Whom to treat and with what?].
Actually is considered that Helicobacter pylori play a major role in the genesis of peptic ulcer. Like in the gastric and duodenal ulcer. When we demonstrate the presence of Helicobacter pylori in the gastric antrum of patients with ulcer they must receive eradication treatment. Another indication for eradication treatment are the patients with malt lymphoma or patients with endoscopical resection of gastric carcinoma. The ideal treatment is the therapy that eradicate 90% of the cases. The most effective are the triple therapies with one proton pump inhibitor with two antibiotics like amoxycillin plus clarithromycin. In Mexico the therapies with metronidazole are not recommended because we have high rates of resistance to this drug 70%. Is not justified to treat patients with non ulcer dyspepsia. We still recommended the schemes of 14 days. A good alternative is the combination of ranitidine bismuth citrate plus two antibiotics. Is possible that in the future we can have a vaccine to eradicate and to prevent the infection.
Dehesa-Violante
M
M
Departamento de Gastroenterología del Hospital de Especialidades del Centro Médico Nacional Siglo XXI, IMSS.
D000230:Adenocarcinoma / Q000209:etiology / Q000382:microbiology; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001428:Bacterial Vaccines / Q000276:immunology / Q000627:therapeutic use; D000075202:Contraindications; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use; D004415:Dyspepsia / Q000209:etiology / Q000382:microbiology; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005753:Gastric Mucosa / Q000382:microbiology; D005756:Gastritis / Q000188:drug therapy* / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000517:prevention & control / Q000628:therapy; D016480:Helicobacter pylori / Q000187:drug effects*; D006635:Histamine H2 Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008795:Metronidazole / Q000494:pharmacology / Q000627:therapeutic use; D008800:Mexico; D054328:Proton Pump Inhibitors; D013274:Stomach Neoplasms / Q000209:etiology / Q000382:microbiology; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000209:etiology; D017211:Treatment Failure
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001428:Bacterial Vaccines; D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D008795:Metronidazole