Molina-Infante Javier, Shiotani Akiko
Department of Gastroenterology, Hospital San Pedro de Alcantara, C/Pablo Naranjo s/n, Caceres 10003, Spain.
Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama Prefecture 701-0114, Japan.
Gastroenterol Clin North Am. 2015 Sep;44(3):519-35. doi: 10.1016/j.gtc.2015.05.004. Epub 2015 Jun 19.
Cure rates greater than 90%-95% should be expected with an antimicrobial therapy for Helicobacter pylori infection. Standard triple therapy does not guarantee these efficacy rates in most settings worldwide anymore. The choice of eradication regimen should be dictated by factors that can predict the outcome: (1) H. pylori susceptibility; (2) patients' history of prior antibiotic therapy; and (3) local data, either resistance patterns or clinical success. Currently, the preferred first-line choices are 14-day bismuth quadruple and 14-day non-bismuth quadruple concomitant therapy. Bismuth quadruple (if not used previously), fluoroquinolone-, furazolidone- and rifabutin-containing regimens might be effective rescue treatments.
对于幽门螺杆菌感染的抗菌治疗，预期治愈率应高于90%-95%。在全球大多数情况下，标准三联疗法已不再能保证这些疗效。根除方案的选择应取决于能够预测结果的因素：（1）幽门螺杆菌的敏感性；（2）患者既往抗生素治疗史；（3）当地数据，即耐药模式或临床治疗成功率。目前，首选的一线治疗方案是14天铋剂四联疗法和14天非铋剂四联伴随疗法。铋剂四联疗法（如果之前未使用过）、含氟喹诺酮、呋喃唑酮和利福布汀的方案可能是有效的补救治疗方法。
