Andreasen J J, Ringsdal V S
Ugeskr Laeger. 1989 Apr 24;151(17):1030-3.
On the basis of possible etiological or pathogenetic significance of Campylobacter pylori for the development, maintenane og recurrence of gastritis and peptic ulceration, a review based on the literature is presented for the sensitivity of the bacteria in vitro and in vivo to antibiotics and preparations employed in the medicinal treatment of gastritis and peptic ulceration. The bacterium is sensitive in vitro to a long series of antibiotics and all of the anti-ulcer agents have, similarly, antibacterial activity in vitro, but, apart from bismuth, only in high concentrations. Among the anti-ulcer agents, only bismuth and, similarly, amoxycillin are capable of eliminating the bacteria from the stomach and this is associated with healing of any gastritis present. Recurrence of infection is observed in more than 50% of the patients after the conclusion of treatment regardless of whether this was antibiotic or bismuth treatment. High in vitro activity of a substance is not synonymous with in vivo activity. A correlation was demonstrated between recurrence of duodenal ulcer and recurrent/persistent infection with Campylobacter pylori. The optimal antibacterial therapeutic strategy is not established and, similarly, no generally accepted indication for specific antimicrobial treatment of Campylobacter pylori associated gastritis or peptic ulceration exists.
基于幽门弯曲菌对胃炎和消化性溃疡的发生、维持及复发可能具有的病因学或发病机制意义，本文根据文献综述了该细菌在体外和体内对用于胃炎和消化性溃疡药物治疗的抗生素及制剂的敏感性。该细菌在体外对一系列抗生素敏感，并且所有抗溃疡药物在体外同样具有抗菌活性，但除铋剂外，只有在高浓度时才有此活性。在抗溃疡药物中，只有铋剂以及阿莫西林能够从胃中清除该细菌，并且这与现存任何胃炎的愈合相关。无论治疗是采用抗生素还是铋剂，超过50%的患者在治疗结束后会出现感染复发。一种物质在体外的高活性并不等同于其在体内的活性。十二指肠溃疡的复发与幽门弯曲菌的反复/持续感染之间存在相关性。最佳抗菌治疗策略尚未确立，同样，对于幽门弯曲菌相关性胃炎或消化性溃疡的特异性抗菌治疗也不存在普遍接受的指征。
