Document Detail

How to treat Helicobacter pylori infection--should treatment strategies be based on testing bacterial susceptibility? A personal viewpoint.
MedLine Citation:
PMID:  8853263     Owner:  NLM     Status:  MEDLINE    
Peptic ulcer disease is an infectious disease. Only antibiotic regimens that achieve a 90% cure should be used to treat this infection. Antimicrobial susceptibility is the main determinant in the success of therapy; cure rates are usually lower in resistant strains. As in any other infectious disease it is essential in treatment studies to stratify results according to pretreatment bacterial susceptibility. Cure-rates have to be reported separately for sensitive and resistant strains. It must be realized that a study achieving a high cure rate with a certain regimen can either have included few patients with resistant strains or, alternatively, the regimen tested can have a high efficacy in resistant strains. This issue is fundamental and only if that information is available, do we know whether or not we can reproduce the results reported in that particular study in a different population. We have reviewed all Helicobacter studies that tested pretreatment bacterial susceptibility. The results achieved with dual therapy, bismuth triple therapy, proton pump inhibitor triple therapy and quadruple therapy in sensitive and resistant strains are discussed. Based on these data, treatment recommendations are made for empirical treatment in areas with low resistance rates and those with high resistance rates. If treatment is individualized and based on the antibiogram then easier, shorter and cheaper regimens seem possible.
W A de Boer; G N Tytgat
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  8     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  1996 Jul 
Date Detail:
Created Date:  1996-12-26     Completed Date:  1996-12-26     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  709-16     Citation Subset:  IM    
Department of Internal Medicine, Sint Anna Hospital, Oss, The Netherlands.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Anti-Ulcer Agents / therapeutic use
Drug Therapy, Combination / therapeutic use
Helicobacter Infections / drug therapy*
Helicobacter pylori / drug effects*
Microbial Sensitivity Tests
Peptic Ulcer / microbiology*
Treatment Outcome
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Ulcer Agents

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