[Present status and future prospect of 3rd rescue regimen for H. pylori infection].
The standard strategy for H. pylori infection in Japan consists of the triple PPI/AMPC/CAM therapy as the first line therapy and the triple PPI/AMPC/MNZ therapy as the second line therapy. 2 or 3% of patients cannot achieve eradication of H. pylori with the above two regimens. Most of them are infected with CAM resistant strains of H. pylori and have the rapid metabolizer genotype of CYP2C19. There are two major third line therapies. One is the dual therapy with high doses (qid dosing) of PPI and AMPC. The other is fluoroquinolone-based therapy. Especially, sitafloxacin, one of the fluoroquinolones, has the lower MIC for H. pylori in comparison with other fluoroquinolones, such as LVFX. Both therapies are expected to achieve the high eradication rate as the 3rd line therapy.
Furuta
Takahisa
T
Center for Clinical Research, Hamamatsu University School of Medicine.
D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D054328:Proton Pump Inhibitors / Q000008:administration & dosage; D015363:Quinolones / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D015363:Quinolones; D000658:Amoxicillin