Basis for the Management of Drug-Resistant Helicobacter pylori Infection

摘要: The discovery that most stomach diseases are a consequence of an Helicobacter pylori infection has completely changed the management diseases. Antibacterials treatment choice in addition to proton pump inhibitors (PPIs) or ranitidine bismuth. We now faced with problem antimicrobial resistance, which is main cause failure. H. acquires resistance essentially via point mutations, and today this phenomenon found antibacterials. important consider clarithromycin, since it first-choice antibacterial clarithromycin highly clinically significant. Quadruple therapy triple therapies amoxicillin-metronidazole tetracycline-metronidazole PPI bismuth can then be used despite possible metronidazole if strain resistant clarithromycin. Resistance both may lead use other combinations, i.e. amoxicillin-rifabutin, amoxicillin-levofloxacin amoxicillin-furazolidone. any these drugs means their must avoided. In some instances, also advisable prescribe amoxicillin as sole antibacterial, quadruple furazolidone instead metronidazole. Although theoretically cure drug-resistant infection, practical limitation availability certain countries. Furthermore, progressive increase drug warrants need for new antibacterials near future.