[Helicobacter pylori resistance: who needs what treatment?].
The standard treatment recommended for eradication of Helicobacter pylori is a combination of three drugs for seven days: one proton pump inhibitor at a double dose and two antibiotics. The high risk of failure - on the order of 30% - justifies routine testing to verify eradication after this first treatment. Verification is most often conducted with a urea breath test, more rarely by endoscopy when endoscopy or gastric histology is otherwise necessary. When eradication fails, longer multidrug treatment with different antibiotics is proposed. The failure rate after second-line treatment is 9-10%. If a third treatment is necessary, bacterial culture is recommended to select antibiotics on the basis of the antibiotic susceptibility testing.
Courillon-Mallet
Anne
A
Service d'Hépato-Gastroentérologie, Centre Hospitalier Intercommunal, Villeneuve-Saint-Georges. anne.courillon-malet@chiv.fr
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001944:Breath Tests; D002986:Clinical Trials as Topic; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D004724:Endoscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008826:Microbial Sensitivity Tests; D018579:Patient Selection; D054328:Proton Pump Inhibitors; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014508:Urea / Q000032:analysis
D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D014508:Urea