Katarzyna Pawlak, Sandra Majcher, Andrzej Pawlik
Rodzaje terapii zakażenia Helicobacter pylori – przeszłość, teraźniejszość, przyszłość
Therapies of Helicobacter pylori infection – past, present and future
Helicobacter pylori (H. pylori) is classified as a pathogen associated with significant morbidity and mortality. Despite years of effort treatment regimens remains modified, while the treatment is still a challenge for physicians. In connection with the extension of resistance to commonly used drugs, especially clarithromycin, the effectiveness of standard triple therapy reached worryingly low levels in many regions of the world. Therefore, the introduction of new treatment regimens, including against highly resistant strains of H. pylori, are the current first-line therapy, demonstrating both high proven to be effective in combating infection, even at ever-increasing resistance to clarithromycin. These patterns may include a quadruple therapy with bismuth, sequential treatment and treatment hybrid (amoxicillin or tinidazole). Due to the rapid development of resistance to quinolones schemes using levofloxacin should be reserved as second-line therapy. In addition, it proposed adding probiotics therapy would enable the acceleration of eradication and reduce the risk of adverse events related to treatment. Today, molecular tests are used to assess the susceptibility of H. pylori, including the degree of resistance to the macrolides and the assessment of cytochrome P450 2C19 which is known to affect the metabolism of proton pump inhibitors (PPIs).
Keywords: Helicobacter pylori, infection, therapy.
© Farm Pol, 2015, 71(11): 679-682