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[幽门螺杆菌耐药性:谁需要何种治疗?]

[Helicobacter pylori resistance: who needs what treatment?].

作者信息

Courillon-Mallet Anne

机构信息

Service d'Hépato-Gastroentérologie, Centre Hospitalier Intercommunal, Villeneuve-Saint-Georges.

出版信息

Presse Med. 2006 Apr;35(4 Pt 2):657-62. doi: 10.1016/s0755-4982(06)74659-0.

Abstract

The standard treatment recommended for eradication of Helicobacter pylori is a combination of three drugs for seven days: one proton pump inhibitor at a double dose and two antibiotics. The high risk of failure - on the order of 30% - justifies routine testing to verify eradication after this first treatment. Verification is most often conducted with a urea breath test, more rarely by endoscopy when endoscopy or gastric histology is otherwise necessary. When eradication fails, longer multidrug treatment with different antibiotics is proposed. The failure rate after second-line treatment is 9-10%. If a third treatment is necessary, bacterial culture is recommended to select antibiotics on the basis of the antibiotic susceptibility testing.

摘要

推荐用于根除幽门螺杆菌的标准治疗方案是三种药物联合使用七天

一种双倍剂量的质子泵抑制剂和两种抗生素。高达30%左右的高失败风险使得在首次治疗后进行常规检测以确认根除效果成为必要。确认通常通过尿素呼气试验进行,在内镜检查或胃组织学检查有其他必要情况时,较少通过内镜检查来进行。当根除失败时,建议使用不同抗生素进行更长疗程的联合治疗。二线治疗后的失败率为9 - 10%。如果需要进行第三次治疗,建议进行细菌培养,以便根据抗生素敏感性试验选择抗生素。

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