[Present status and future prospects of third line rescue regimens for H. pylori infection]

Recent reports have suggested that the candidates of the third rescue regimens for H. pylori infection in Japan are fluoroquinolone-based regimens and the dual therapy with high doses of proton pump inhibitor and amoxicillin. Of fluoroquinolones, sitafloxacin has the strong anti-H. pylori effect as AMPC has and is effective for strains resistant to levofloxacin. Sitafloxacin-based regimens have been reported to yield relatively sufficient eradication rates as the third line therapy. The dual therapy with high doses of proton pump inhibitor and amoxicillin has also been reported to attain the sufficient rescue rates. To achieve the high rescue eradication rates, the eradication regimens must be designed based on well-understanding of reasons for eradication failure, such as the resistance patterns of the bacteria, and the pharmacological characteristics of agents used for H. pylori eradication therapy.