Effective regimens for the treatment of Helicobacter pylori infection

TY - JOUR

T1 - Effective regimens for the treatment of Helicobacter pylori infection

AU - Morgner, Andrea

AU - Labenz, Joachim

AU - Miehlke, Stephan

PY - 2006/9

Y1 - 2006/9

N2 - Successful Helicobacter pylori eradication therapy remains a challenge in medical practice. Currently, a proton pump inhibitor-based triple therapy containing clarithromycin, amoxicillin or nitroimidazole for 7 days is the recommended first-line treatment approach with an expected eradication success rate of approximately 80%. As a second-line treatment option in the case of failure, a ranitidine bismuth citrate-based quadruple therapy is currently recommended curing another 80% of patients, leaving a subset of patients with persistent H. pylori infection. For these patients, promising rescue options have been evaluated including regimens that contain rifabutin, quinolones, furazolidone or high-dose amoxicillin. The role of susceptibility testing is still under discussion. It is not generally recommended prior to first-line treatment but guidelines propose a role for culture and antibiotic sensitivity testing after failure of the second attempt. Meanwhile, data on the geographic distribution of resistance pattern are available and may guide therapeutic decisions with regard to the combination of antibiotics chosen for the individual patients aiming at 100% cure rate in each individual patient.

AB - Successful Helicobacter pylori eradication therapy remains a challenge in medical practice. Currently, a proton pump inhibitor-based triple therapy containing clarithromycin, amoxicillin or nitroimidazole for 7 days is the recommended first-line treatment approach with an expected eradication success rate of approximately 80%. As a second-line treatment option in the case of failure, a ranitidine bismuth citrate-based quadruple therapy is currently recommended curing another 80% of patients, leaving a subset of patients with persistent H. pylori infection. For these patients, promising rescue options have been evaluated including regimens that contain rifabutin, quinolones, furazolidone or high-dose amoxicillin. The role of susceptibility testing is still under discussion. It is not generally recommended prior to first-line treatment but guidelines propose a role for culture and antibiotic sensitivity testing after failure of the second attempt. Meanwhile, data on the geographic distribution of resistance pattern are available and may guide therapeutic decisions with regard to the combination of antibiotics chosen for the individual patients aiming at 100% cure rate in each individual patient.

KW - Anti-Bacterial Agents

KW - Dose-Response Relationship, Drug

KW - Drug Therapy, Combination

KW - Helicobacter Infections

KW - Helicobacter pylori

KW - Humans

KW - Treatment Outcome

KW - Journal Article

KW - Review

U2 - 10.1517/13543784.15.9.995

DO - 10.1517/13543784.15.9.995

M3 - SCORING: Journal article

C2 - 16916269

VL - 15

SP - 995

EP - 1016

JO - EXPERT OPIN INV DRUG

JF - EXPERT OPIN INV DRUG

SN - 1354-3784

IS - 9

ER -