Murakami K, Satoh R, Okimoto T, Kagawa J, Fujioka T, Kodama M
Second Department of Internal Medicine, Oita Medical University.
Nihon Rinsho. 2001 Feb;59(2):308-13.
There is general agreement that H. pylori should be eradicated in patients with peptic ulcers. But the optimal therapeutical regimen to be used still remains a matter for many investigations. An increase in the prevalence of antibiotic-resistant H. pylori strains has been reported recently. The recommended drugs for the eradication in Japan are clarithromycin (CAM) and amoxicillin (AMPC) because metronidazole (MNZ) is anti-parasites drug in Japan. A total of 392 H. pylori strains in the last twelve years were tested for sensitivity to CAM, MNZ, and AMPC. The Primary resistance of H. pylori to CAM, MNZ, and AMPC were found in 10.2%, 26.5%, and 0.3% strains, respectively. The resistant strains to CAM were gradually increasing in the last few years. The eradication therapies which do not increase antibiotics resistant strains after eradication failure were reported. The recommendation for eradication in patients with peptic ulcer disease includes those with bleeding ulcers. The pretreatment with proton pump inhibitors (PPI) does not influence the success of PPI-based triple therapy in eradicating H. pylori.
人们普遍认为，幽门螺杆菌（H. pylori）阳性的消化性溃疡患者应根除幽门螺杆菌。但目前仍有许多研究致力于探寻最佳治疗方案。最近有报道称，对多种抗生素耐药的幽门螺杆菌菌株的流行率呈上升趋势。在日本，推荐用于根除幽门螺杆菌的药物是克拉霉素（CAM）和阿莫西林（AMPC），因为甲硝唑（MNZ）在日本被归类为抗寄生虫药物。在过去十二年中，共检测了392株幽门螺杆菌对CAM、MNZ和AMPC的敏感性。结果发现，幽门螺杆菌对CAM、MNZ和AMPC的原发性耐药率分别为10.2%、26.5%和0.3%。在过去几年中，对CAM耐药的菌株数量逐渐增加。有报道称，某些根除疗法在根除失败后不会增加抗生素耐药菌株。对于消化性溃疡疾病患者（包括出血性溃疡患者）的根除治疗也有相应建议。质子泵抑制剂（PPI）预处理并不影响基于PPI的三联疗法根除幽门螺杆菌的成功率。
