[Current perspective of the resistance of Helicobacter pylori strains to antimicrobial drugs].
A significant increase in H. pylori resistance to clarithromycin and metronidazole has been proven in both children and adults. Clarithromycin with resistance over 20 % and metronidazole with resistance over 40 % are not recommended for treating H. pylori infection. Preferred treatment regimens were designed to reflect the current situation. The classical regimen PPI + AMO + CLA (MET) can be used in cases where the resistance against CLA and MET is lower than stated above. In the opposite case, a combination of PPI + AMO + levofloxacin (or rifabutin, or furazolidone) must be used. In many countries, this regimen is already the first-choice treatment. The 4-combination with bismuth is suitable in case of 3-combination treatment failure, or in patients allergic to penicillin.
Department of Internal Medicine, Charles University, University Hospital Motol, Prague, Czech Republic. lochon@post.cz
Jindra
J
Lochmannová
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017291:Clarithromycin / 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; D064704:Levofloxacin; D008795:Metronidazole / Q000008:administration & dosage*; D015242:Ofloxacin / Q000008:administration & dosage; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D064704:Levofloxacin; D015242:Ofloxacin; D017291:Clarithromycin