根据抗生素耐药性的Helicobacter pylori治疗的有效性
Luis Bujanda1, Olga P Nyssen2, June Ramos1
1Department of Gastroenterology, Biodonostia Health Research Institute, San Sebastián; CIBERehd, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid; Department of Medicine, Universidad Del País Vasco (UPV/EHU), San Sebastián, Spain.
The American journal of gastroenterology
|November 20, 2023
概括
在欧洲,有效地根除Helicobacter pylori取决于抗生素耐药性. 含比斯穆特的四重疗法和3合一囊显示出高效,即使在克拉里胺或甲尼达抗性.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 抗生素耐药性对Helicobacter pylori根除成功有重大影响.
- 对抗耐药菌株的治疗疗效的评估对于有效的H. pylori管理至关重要.
研究的目的:
- 评估欧洲一线和救援H. pylori治疗的有效性.
- 分析与抗生素耐药性模式相关的治疗结果.
主要方法:
- 未来,多中心国际注册 (欧洲H. pylori管理注册).
- 从2013-2021年包括培养诊断的成年患者.
- 分析了2852名天真和1118名非天真患者的培养结果.
主要成果:
- 在未经治疗的患者中,克拉里胺素,甲尼达和金诺隆的耐药性分别为22%,27%和18%.
- 3-in-1单片囊 (91%) 和芝麻四重疗法 (91%) 是最有效的,无论耐药性如何.
- 在未经试验的患者中,抗药率更高 (分别为49%,41%,24%). 3-in-1单片囊 (87%) 和勒沃素三重疗法 (85%) 显示出令人鼓舞的结果.
结论:
- 对于高耐药性区域的天真患者,建议使用3合1单片囊,四重 bismuth 和tinidazole 同时治疗.
- 对于未经过试验的患者来说,3-in-1单片囊和levofloxacin三重疗法是有效的选择.
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