The Optimal First-Line Therapy of<i>Helicobacter pylori</i>Infection in Year 2012

  • Chao-Hung Kuo
    Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
  • Fu-Chen Kuo
    Department of Health Management, I-Shou University, E-Da Hospital, Kaohsiung County 824, Taiwan
  • Huang-Ming Hu
    Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
  • Chung-Jung Liu
    Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
  • Sophie S. W. Wang
    Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
  • Yen-Hsu Chen
    Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
  • Ming-Chia Hsieh
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan
  • Ming-Feng Hou
    Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
  • Deng-Chyang Wu
    Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan

説明

<jats:p>This paper reviews the literature about first-line therapies for<jats:italic>H. pylori</jats:italic>infection in recent years. First-line therapies are facing a challenge because of increasing treatment failure due to elevated antibiotics resistance. Several new treatment strategies that recently emerged to overcome antibiotic resistance have been surveyed. Alternative first-line therapies include bismuth-containing quadruple therapy, sequential therapy, concomitant therapy, and hybrid therapy. Levofloxacin-based therapy shows impressive efficacy but might be employed as rescue treatment due to rapidly raising resistance. Rifabutin-based therapy is also regarded as a rescue therapy. Several factors including antibiotics resistance, patient compliance, and CYP 2C19 genotypes could influence the outcome. Clinicians should use antibiotics according to local reports. It is recommended that triple therapy should not be used in areas with high clarithromycin resistance or dual clarithromycin and metronidazole resistance.</jats:p>

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