title: A clinician's guide to salvage therapy for persistent Helicobacter pylori infection.
abstract: Since its discovery in 1982, Helicobacter pylori has been established as a common cause of gastritis and peptic ulcer disease. H pylori infection is also closely associated with several gastric malignancies and has consequently been designated a human carcinogen. As these associations have become increasingly recognized and pursued, a growing challenge facing today's clinicians is the management of patients with persistent H pylori despite previous attempts to treat the infection. In developed countries, the most popular treatment regimen remains traditional triple therapy consisting of a proton pump inhibitor, clarithromycin, and amoxicillin for 7 to 14 days. Unfortunately, eradication rates with traditional triple therapy are disappointing, with infection persisting in as many as 25% of those treated. This article addresses the management of patients with persistent H pylori infection, including indications for confirmatory testing, reasons for treatment failure, and established and emerging salvage regimens for patients with persistent infection.
authors: Department of Internal Medicine, Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI 48109-5682, USA.
authors: Jay
authors: J
authors: Luther
authors: William D
authors: WD
authors: Chey
authors: Richard J
authors: RJ
authors: Saad
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001706:Biopsy; D001944:Breath Tests; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D005243:Feces / Q000382:microbiology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors