Abadi Amin Talebi Bezmin, Ierardi Enzo
Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.
Front Pharmacol. 2019 Apr 5;10:316. doi: 10.3389/fphar.2019.00316. eCollection 2019.
Within a short time after the discovery of , its critical role in many gastroduodenal disorders became evident. Many and data have proven that infection should be treated in order to avoid lasting colonization which may lead to problematic gastroduodenal diseases. Probiotics, preventive and therapeutic vaccines and antibiotic therapy are the main options proposed to cure these disorders. 25 years ago, triple therapy including a traditional proton pump inhibitor (PPI) and two antibiotics (amoxicillin and clarithromycin or metronidazole) was defined as the best therapy formulation for the infection. With the strongly decreased effectiveness of this scheme, many empirical therapeutic regimens have been developed. However, the prevalence of resistance is increasing worldwide and reveals important geographic differences and even the most recent and effective regimens show some critical points. Therefore, efficacy of vonoprazan-based therapy in regions with low rate of clarithromycin resistance may be limited. In this review, we attempt to open a new window to overcome the problem of antibiotic resistance to . In fact, we focused our attention on the possibility that conventional PPI may be replaced by vonoprazan, thus giving rise to the beginning of a new era characterized by an improved therapeutic option for infection. Therefore, we hypothesize that switching to vonoprazan as a novel acid blocker for treatment might allow an unexpected reassessment of the triple therapy, at least in regions with low rate of clarithromycin resistance. Nevertheless, this optimistic view of the problem could be disproved by the possible failure of vonoprazan based therapeutic regimens outside of Japan in geographic areas characterized by different rates of antibiotic resistances.
在发现[具体事物未提及]后不久，其在许多胃十二指肠疾病中的关键作用就变得明显起来。许多[具体事物未提及]和[具体事物未提及]数据已经证明，为避免可能导致问题性胃十二指肠疾病的持续定植，感染应予以治疗。益生菌、预防性和治疗性疫苗以及抗生素疗法是为治愈这些疾病而提出的主要选择。25年前，包括传统质子泵抑制剂（PPI）和两种抗生素（阿莫西林和克拉霉素或甲硝唑）的三联疗法被定义为治疗[具体感染未提及]感染的最佳治疗方案。随着该方案有效性的大幅下降，许多经验性治疗方案已经被开发出来。然而，耐药性在全球范围内呈上升趋势，并且显示出重要的地理差异，甚至最新且有效的方案也存在一些关键点。因此，在克拉霉素耐药率较低的地区，基于沃克帕唑的疗法的疗效可能有限。在本综述中，我们试图打开一扇新的窗口来克服对[具体事物未提及]的抗生素耐药性问题。事实上，我们将注意力集中在传统PPI可能被沃克帕唑取代的可能性上，从而开启一个以改善[具体感染未提及]感染治疗选择为特征的新时代。因此，我们假设改用沃克帕唑作为治疗[具体事物未提及]的新型酸阻滞剂可能会使三联疗法得到意想不到的重新评估，至少在克拉霉素耐药率较低的地区是这样。然而，在日本以外、抗生素耐药率不同的地理区域，基于沃克帕唑治疗方案可能失败，这可能会推翻对该问题的这种乐观看法。
