Effective regimens for the treatment of Helicobacter pylori infection
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Effective regimens for the treatment of Helicobacter pylori infection. / Morgner, Andrea; Labenz, Joachim; Miehlke, Stephan.
In: EXPERT OPIN INV DRUG, Vol. 15, No. 9, 09.2006, p. 995-1016.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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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 -