PMID: 18714738Aug 22, 2008Paper

Clinical aspects of Helicobacter pylori infection

Polskie Archiwum Medycyny Wewnętrznej
Witold Bartnik

Abstract

The Helicobacter pylori (Hp) infection is common. However, only 10-20% of infected individuals require antibacterial treatment. The main indications to such treatment are peptic ulcer disease, atrophic gastritis, dyspeptic symptoms, previous surgical procedure for gastric cancer, family history of gastric cancer and low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. The treatment may also be undertaken at the patient's request. To detect the infection the urease test (when the patient has indications for gastroscopy), the urea breath test or serologic test are most commonly used. A standard treatment of Hp infection consists of a 7-day administration of one of the proton pump inhibitors and 2 out of 3 antibiotics such as amoxicillin, clarithromycin and metronidazole. After failure of the first-line treatment, the recommended second choice treatment is a quadruple treatment regimen consisting of bismuth salts, tetracycline, metronidazole and proton pump inhibitor. European guidelines (Maastricht III) allow the use of the quadruple treatment regimen already as the first choice treatment and therapy prolongation up to 14 days. Ineffectiveness of the second-line treatment is an indication for antimicrobial suscept...Continue Reading

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