Authors: Nakajima, S.; Graham, D.Y.; Hattori, T.; Bamba, T.

Source: Current Pharmaceutical Design, Volume 6, Number 15, 1 October 2000 , pp. 1515-1529(15)

Publisher: Bentham Science Publishers

Abstract:

The approach to the patient with suspected H. pylori infection consists of an adequate indication to test for the presence of the infection, choice of an appropriate antimicrobial regimen, and education about its use and side effects, followed by post-therapy testing to confirm cure. We review the drugs and regimens for H. pylori eradication and present a strategy for treating the infection. The major factor in choosing an antibiotic regimen is the pattern of antibiotic resistance in the community. Triple therapy with a proton pump inhibitor (PPI) or ranitidine bismuth citrate (RBC) and two antimicrobials is recommended as the first choice regimen. In regions where metronidazole and clarithromycin resistance are common, initial therapy with quadruple therapy consisting of bismuth, metronidazole, tetracycline, and a PPI is recommended. In general, higher doses and longer durations are associated with better outcomes. For this reason we recommend that the minimum duration of 10 days and we prefer 14 days. The actual choice of the antimicrobial combination will also be influenced by the drugs approved by the local regulatory bodies. Side effects, eradication failure and current as well as future designs of eradication therapies are also discussed.

Keywords: Macrolides; Proton Pump Inhibitors (PPIs); Histamine H2-Receptor Antagonists (H2Ras); Ranitidine-bismuth Citrate (RBC)

Document Type: Review article

DOI: http://dx.doi.org/10.2174/1381612003399013

Publication date: 2000-10-01

More about this publication?

• Current Pharmaceutical Design publishes timely in-depth reviews covering all aspects of current research in rational drug design. Each issue is devoted to a single major therapeutic area. A Guest Editor who is an acknowledged authority in a therapeutic field has solicits for each issue comprehensive and timely reviews from leading researchers in the pharmaceutical industry and academia.
  
  Each thematic issue of Current Pharmaceutical Design covers all subject areas of major importance to modern drug design, including: medicinal chemistry, pharmacology, drug targets and disease mechanism.

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