title: [Helicobacter pylori--overview of therapy].
abstract: The clinical significance of Helicobacter pylori infection in the etiopathogenesis of many gastroduodenal disorders, especially peptic ulcer disease and current awareness of the benefits of its eradication has entirely changed the current treatment of these diseases. Eradication was already defined as the disappearance of Helicobacter pylori from the gastric mucosa (finding negativization) confirmed at least 4 weeks (or later) after completed antibiotic eradication therapy. The regimen has to be simple, cheap and tolerable so that the patient could carry it out completely and as easy as possible (good compliance is required). The success of Helicobacter pylori eradication, evaluated by the strict "intention-to-treat" criteria, has to be higher than 80%. Current modern therapy should be triple and not longer than 7 days. One of three proton pump inhibitors is recommended as the antisecretory component (omeprazole, pantoprazole or lansoprazole). Two of three following antibiotis is added to this therapy: metronidazole/tinidazole, clarithromycin or amoxicillin. Treatment failure and growing number of antimicrobial resistant Helicobacter pylori strains require new ways of therapy and more effective drugs. Our results of 7-, 10- and 14-day therapy consisting of omeprazole, amoxicillin and metronidazole are poorer than those of drug combination including clarithromycin instead of amoxicillin. The results of Clinical Hospital "Merkur" showed that combination of amoxicillin, metronidazole and pantoprazole was more effective than the same combination with omeprazole, and the opposite was true for metronidazole and azithromycin combined with omeprazole and pantoprazole, respectively. The results of other medical centers prescribing the same eradication protocols were completely different. The differences are probably caused by poor patient compliance.
authors.affiliation: Klinicka bolnica Merkur Medicinskog fakulteta Sveucilista u Zagrebu, Zajceva 19, 10000 Zagreb.
authors.forename: Miroslava
authors.initials: M
authors.lastname: Katicić
authors.forename: Marija
authors.initials: M
authors.lastname: Prskalo
authors.forename: Mirjána
authors.initials: M
authors.lastname: Tićak
authors.forename: Branka
authors.initials: B
authors.lastname: Sabarić
authors.forename: Marinko
authors.initials: M
authors.lastname: Marusić
authors.forename: Marko
authors.initials: M
authors.lastname: Banić
authors.forename: Mladen
authors.initials: M
authors.lastname: Buljevac
authors.forename: Milan
authors.initials: M
authors.lastname: Kujundzić
authors.forename: Davor
authors.initials: D
authors.lastname: Jelić
authors.forename: Mato
authors.initials: M
authors.lastname: Kozić
authors.forename: Silvio
authors.initials: S
authors.lastname: Mihaljević
authors.forename: Zvonko
authors.initials: Z
authors.lastname: Mićunović
authors.forename: Bruno
authors.initials: B
authors.lastname: Skurla
authors.forename: Tajana
authors.initials: T
authors.lastname: Filipec
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005756:Gastritis / Q000188:drug therapy / Q000382:microbiology*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology*; D054328:Proton Pump Inhibitors
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors