期刊
THERAPEUTIC ADVANCES IN GASTROENTEROLOGY
卷 5, 期 2, 页码 103-109出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/1756283X11432492
关键词
bismuth salts; clarithromycin; BMT (Pylera (R)); sequential therapy; antimicrobial susceptibility testing
A proton-pump inhibitor (PPI), clarithromycin-based, triple therapy has been the recommended treatment for Helicobacter pylori eradication for the past 15 years. Due to a steady increase in H. pylori resistance to clarithromycin, this triple clarithromycin-based treatment has become progressively less efficacious. Several approaches are available to address this situation: one is to test for clarithromycin resistance so that this triple clarithromycin-based regimen is given only to those who will benefit; a second is to prescribe the drugs sequentially, beginning with amoxicillin and a PPI followed by clarithromycin and metronidazole, again with a PPI or the four drugs prescribed concomitantly; a third alternative is to use bismuth-based quadruple therapy, PPI plus a standardized three-in-one capsule, bismuth subcitrate potassium, metronidazole, and tetracycline (BMT, sold under licence as Pylera (R)). The advantages of these different approaches are reviewed, including the relevance of BMT three-in-one capsule in clinical practice.
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