克拉霉素
甲硝唑
幽门螺杆菌
医学
阿莫西林
养生
内科学
胃炎
胃肠病学
抗生素
质子抑制剂泵
微生物学
生物
作者
Cynthia T. Nguyen,Kyle A. Davis,Sarah A. Nisly,Julius Li
摘要
Helicobacter pylori infection can lead to gastritis, gastric and duodenal ulcers, and gastric cancer. Consequently, complete eradication is the goal of therapy. First‐line therapy for H. pylori infection includes clarithromycin triple therapy (clarithromycin, proton pump inhibitor [PPI], and amoxicillin or metronidazole), bismuth quadruple therapy (bismuth salt, PPI, tetracycline, and metronidazole or amoxicillin), or concomitant therapy (clarithromycin, PPI, amoxicillin, and metronidazole). However, many patients have relative contraindications to the antibiotics included in these regimens, making therapy selection difficult. Furthermore, failure of initial therapy makes selection of second‐line therapy challenging due to concerns for potential resistance to agents included in the initial regimen. This review discusses H. pylori microbiology, including antibiotic resistance, and summarizes the existing evidence for first‐ and second‐line treatment regimens that may be considered for special populations such as patients with penicillin allergies, patients with or at risk for QTc‐interval prolongation, and patients who are pregnant, breastfeeding, or elderly.
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