Pharmacologic aspects of eradication therapy for Helicobacter pylori Infection.
The commonly used regimens for the eradication of Helicobacter pylori infection consist of administration of proton pump inhibitors (PPIs) and 1 to 3 antimicrobial agents, such as amoxicillin, clarithromycin, metronidazole, fluoroquinolone, or tetracycline. Each agent has its own pharmacologic characteristics. PPIs are metabolized by cytochrome P450 2C19 (CYP2C19), which is polymorphic. CYP2C19 genotypic differences in the pharmacokinetics and pharmacodynamics of PPIs influence the eradication rates of H pylori infection by PPI-containing regimens. Amoxicillin is a time-dependent antibiotic, whereas clarithromycin, metronidazole, tetracycline, and fluoroquinolone are not. The plasma half-life of antimicrobial agents also differs among these antibiotics. To achieve consistently high eradication rates, the eradication regimens must be designed based on a good understanding of the resistance patterns of the bacteria and the pharmacologic characteristics of the agents used for H pylori eradication therapy.
Center for Clinical Research, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higsahi-Ku, Hamamatsu 431-3192, Japan. furuta@hama-med.ac.jp
Takahisa
T
Furuta
David Y
DY
Graham
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005767:Gastrointestinal Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control*; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000517:prevention & control*; D016480:Helicobacter pylori; D006801:Humans; D010597:Pharmacogenetics; D054328:Proton Pump Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D041742:Upper Gastrointestinal Tract / Q000382:microbiology / Q000473:pathology
D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors