Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia.
Department of Medicine, Najran University, Najran, Kingdom of Saudi Arabia.
Saudi J Gastroenterol. 2023 Nov-Dec;29(6):326-346. doi: 10.4103/sjg.sjg_288_22.
The eradication rates for Helicobacter pylori globally are decreasing with a dramatic increase in the prevalence of antibiotic resistant bacteria all over the world, including Saudi Arabia. There is no current consensus on the management of H. pylori in Saudi Arabia. The Saudi Gastroenterology Association developed these practice guidelines after reviewing the local and regional studies on the management of H. pylori. The aim was to establish recommendations to guide healthcare providers in managing H. pylori in Saudi Arabia. Experts in the areas of H. pylori management and microbiology were invited to write these guidelines. A literature search was performed, and all authors participated in writing and reviewing the guidelines. In addition, international guidelines and consensus reports were reviewed to bridge the gap in knowledge when local and regional data were unavailable. There is limited local data on treatment of H. pylori. The rate of clarithromycin and metronidazole resistance is high; therefore, standard triple therapy for 10-14 days is no longer recommended in the treatment of H. pylori unless antimicrobial susceptibility testing was performed. Based on the available data, bismuth quadruple therapy for 10-14 days is considered the best first-line and second-line therapy. Culture and antimicrobial susceptibility testing should be considered following two treatment failures. These recommendations are intended to provide the most relevant evidence-based guidelines for the management of H. pylori infection in Saudi Arabia. The working group recommends further studies to explore more therapeutic options to eradicate H. pylori.
全球范围内幽门螺杆菌的根除率正在下降，而世界各地包括沙特阿拉伯在内的抗生素耐药菌的流行率却在急剧上升。目前，沙特阿拉伯还没有关于幽门螺杆菌管理的共识。沙特阿拉伯胃肠病学协会在审查了当地和区域关于幽门螺杆菌管理的研究后制定了这些实践指南。目的是制定建议，指导沙特阿拉伯的医疗保健提供者管理幽门螺杆菌。幽门螺杆菌管理和微生物学领域的专家应邀撰写了这些指南。进行了文献检索，所有作者都参与了指南的撰写和审查。此外，还审查了国际指南和共识报告，以弥补当地和区域数据缺乏时的知识差距。关于幽门螺杆菌治疗的本地数据有限。克拉霉素和甲硝唑的耐药率很高；因此，除非进行了抗菌药物敏感性测试，否则不再推荐标准的三联疗法（10-14 天）治疗幽门螺杆菌。根据现有数据，铋剂四联疗法（10-14 天）被认为是最佳的一线和二线治疗方案。在两次治疗失败后，应考虑进行培养和抗菌药物敏感性测试。这些建议旨在为沙特阿拉伯的幽门螺杆菌感染管理提供最相关的基于证据的指南。工作组建议进一步研究以探索更多的治疗选择来根除幽门螺杆菌。
