Kim Su Young, Chung Jun-Won
Divison of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea.
Divison of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon 21565, Korea.
Antibiotics (Basel). 2020 Jul 23;9(8):436. doi: 10.3390/antibiotics9080436.
Antibiotic resistance is the major reason for treatment failure, and the increasing frequency of antibiotic resistance is a challenge for clinicians. Resistance to clarithromycin and metronidazole is a particular problem. The standard triple therapy (proton pump inhibitor, amoxicillin, and clarithromycin) is no longer appropriate as the first-line treatment in most areas. Recent guidelines for the treatment of infection recommend a quadruple regimen (bismuth or non-bismuth) as the first-line therapy. This treatment strategy is effective for areas with high resistance to clarithromycin or metronidazole, but the resistance rate inevitably increases as a result of prolonged therapy with multiple antibiotics. Novel potassium-competitive acid blocker-based therapy may be effective, but the data are limited. Tailored therapy based on antimicrobial susceptibility test results is ideal. This review discussed the current important regimens for treatment and the optimum eradication strategy.
抗生素耐药性是治疗失败的主要原因，而抗生素耐药性频率的增加对临床医生来说是一项挑战。对克拉霉素和甲硝唑的耐药性是一个特别的问题。标准三联疗法（质子泵抑制剂、阿莫西林和克拉霉素）在大多数地区已不再适合作为一线治疗。近期的感染治疗指南推荐四联疗法（含铋或不含铋）作为一线治疗方案。这种治疗策略对克拉霉素或甲硝唑耐药性高的地区有效，但由于多种抗生素的长期治疗，耐药率不可避免地会上升。基于新型钾离子竞争性酸阻滞剂的疗法可能有效，但数据有限。基于抗菌药敏试验结果的个体化治疗是理想的。本综述讨论了当前治疗的重要方案和最佳根除策略。
