Treatment for Helicobacter pylori infection, an overview

نویسنده

  • Eskandar Hajiani
چکیده

The best treatment schedule for eradication of Helicobacter pylori in Iran is a type of quadruple therapy for a minimum duration of two weeks. Since, clarithromycin and furazolidone based quadruple regimen has the highest eradication rate, it can be considered as the first line therapy. Metronidazole based quadruple therapy may be used as an alternative choice of first line therapy. It is also important to note that furazolidone based regimens could induce side effects and are highly contraindicated in patients with G6PD deficiency. We recommend triple therapy with a proton pump inhibitor (PPI) (eg, lansoprazole 30mg twice daily, omeprazole 20mg twice daily, pantoprazole 40mg twice daily, rabeprazole 20mg twice daily, or esomeprazole 40mg once daily), amoxicillin (1g twice daily), and clarithromycin (500mg twice daily) for 10 days to two weeks. We suggest substitution of amoxicillin with metronidazole (500mg twice daily) only in penicillin-allergic individuals since metronidazole resistance is common and can reduce the efficacy of treatment. An initial attempt at eradicating H. pylori fails in as many as 20 percent of patients. For patients failing one course of H. pylori treatment, we suggest either an alternate regimen using a different combination of medications, or preferably quadruple therapy consisting of a PPI twice daily and bismuth-based triple therapy preferably given with meals and an evening snack for 14 days. For those failing two attempts at treatment, it is especially important to reinforce compliance with medications. Culture with antibiotic sensitivity testing can be done to guide subsequent treatments but generally we forgo culture in favor of "rescue" therapy. We suggest levofloxacin (250mg), amoxicillin (1g) and a PPI each given twice daily for two weeks. Alternative dosing regimens have also been suggested.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Antibacterial activities of Galla rhois extracts against Helicobacter pylori infection

In this study, a medicinal plant, Galla rhois (GR), was examined and screened for its anti-Helicobacter pylori activity. Galla rhois was extracted with 70% ethanol. Inhibitory zone tests, as in vitro assays, and an in vivo study using a Mongolian gerbil (Meriones unguiculatus) model were performed. The safety of the GR extract was then evaluated in an animal study. The Galla rhois extract demon...

متن کامل

Experimental infection of stray cats with human isolates of Helicobacter pylori

To improve our understanding of Helicobacter  infection in cats and to determine whether they are reservoirs for H. pylori  and sources of zoonotic transmission to humans, we selected cats as an experimental animal model for gastric colonization by H. pylori. Sixteen stray cats underwent Helicobacter  eradication treatment followed by three consecutive oral inoculations of a cocktail of human H...

متن کامل

TREATMENT OF HELICOBACTER PYLORI (H. PYLORI) INFECTION IN CHILDREN: A PROSPECTIVE STUDY COMPA R ING TWO DIFFERENT THERAPEUTIC REGIMENS

During a period of 10 months from May to February 1995, 120 children (72 girls, 48 boys) with an age range of 4-16 years (mean age 10.87, S.D.±2.7) with chronic abdominal pain who had an abnormal endoscopy (gastroduodenal mucosal defect) and positive urease test were treated for H. pylori. Patients were treated randomly with either metronidazole and amoxicillin (double therapy, group A) or ...

متن کامل

Role of Probiotics in the Management of Helicobacter Pylori Infection

Helicobacter pylori is a gram-negative, spiral-shaped, microaerophilic organism that colonizes the stomach of humans and causes chronic-active gastritis, peptic ulcer disease, and gastric cancers, including adenocarcinoma of the stomach and MALT (mucosal-associated lymphoid tumor) lymphomas. H. pylori colonizes the stomach of over 50 % the world’s human population, primarily those who reside in...

متن کامل

Comparison of the effect of levofloxacin-based three-drug regimen with clarithromycin-based four-drug regimen in the treatment of Helicobacter pylori infection in Birjand: Short Communication

Given the high prevalence of Helicobacter pylori infection in Iran, eradicating it with an effective, low-cost, and easy diet is one of the challenges ahead The aim of this study was designed to compare the effect of "levofloxacin-based regimen “with” clarithromycin-based regimen” in the treatment of Helicobacter pylori. This quasi-experimental study was performed on 161 patients with Helicobac...

متن کامل

Severe Anemia and Helicobacter Pylori Infection in school age Children; A case reports

Abstract Background Iron-deficiency anemia is a widespread public health problem with major consequences for human health especially, children. However, in a fraction of patients an underlying cause is never found during routine investigation. Recent studies have suggested an association between Helicobacter pylori (H. Pylori) infection and iron-deficiency ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2009