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2017 ; 5
(ä): 23
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Update on the first-line treatment for Helicobacter pylori infection - a
continuing challenge from an old enemy
#MMPMID28702193
Huang CC
; Tsai KW
; Tsai TJ
; Hsu PI
Biomark Res
2017[]; 5
(ä): 23
PMID28702193
show ga
Because the prevalence of antibiotic resistance markedly increases with time
worldwide, anti-H. pylori treatment is continuing to be a great challenge
forsphysicians in clinical practice. The Real-world Practice & Expectation of
Asia-Pacific Physicians and Patients in Helicobacter Pylori Eradication (REAP-HP)
Survey demonstrated that the accepted minimal eradication rate of anti-H. pylori
regimen in H. pylori-infected patients was 91%. The Kyoto Consensus Report on
Helicobacter Pylori Gastritis also recommended that, within any region, only
regimens which reliably produce eradication rates of ?90% in that population
should be used for empirical treatment. This article is aimed to review current
first-line eradication regimens with a per-protocol eradication rate exceeding
90% in most geographic areas. In regions with low (?15%) clarithromycin
resistance, 14-day hybrid (or reverse hybrid), 10 ~ 14-day sequential, 7 ~ 14-day
concomitant, 10 ~ 14-day bismuth quadruple or 14-day triple therapy can achieve a
high eradication rate in the first-line treatment of H. pylori infection.
However, in areas with high (>15%) clarithromycin resistance, standard triple
therapy should be abandoned because of low eradication efficacy, and 14-day
hybrid (or reverse hybrid), 10 ~ 14-day concomitant or 10 ~ 14-day bismuth
quadruple therapy are the recommended regimens. If no recent data of local
antibiotic resistances of H. pylori strains are available, universal high
efficacy regimens such as 14-day hybrid (or reverse hybrid), concomitant or
bismuth quadruple therapy can be adopted to meet the recommendation of consensus
report and patients' expectation.