量身定制的治疗使用比斯穆特补充剂 标准三重疗法与同时治疗:一线治疗方案治疗杆菌感染
Soo Yeon Choi1, Na Rae Lim1, Woo Chul Chung1
1Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
概括
根据标准三重疗法 (STT) 加 bismuth 的量身定制疗法 (TT) 显示,Helicobacter pylori 根除率与同时治疗 (CT) 相同. 建议在耐药性上升的情况下减少不必要的抗生素使用.
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:
- 对Helicobacter pylori (H. pylori) 感染的第一线并发疗法 (CT) 提供了高的根除率.
- 抗生素耐药性需要评估替代H. pylori治疗策略.
- 量身定制治疗 (TT) 旨在优化H. pylori根除,同时最大限度地减少抗生素暴露.
研究的目的:
- 为了比较量身定制疗法 (TT) 与芝麻添加标准三重疗法 (STT) 与同时治疗 (CT) 的疗效,用于H. pylori根除.
- 评估克拉里思罗米辛耐药性对TT疗效的影响.
- 评估多重PCR在指导H. pylori治疗决策中的作用.
主要方法:
- 一项连续的研究包括了210名感染H. pylori的患者.
- 患者被分配到TT (n=105) 或CT (n=105).
- TT涉及多重PCR检测克拉里素耐药性,指导使用14天STT或14天双珠添加STT的治疗. CT涉及一个10天的疗程.
主要成果:
- 每项方案分析显示,TT的H. pylori根除率为89.2%,CT的81.6%,没有显著差异 (P=0.12).
- 在32.4%的患者中通过PCR检测出了克拉里素耐药性.
- 在克拉里思罗米辛耐药性患者中,树脂添加STT实现了76.5%的根除率.
结论:
- 量身定制治疗 (TT) 的疗效与用于根除H. pylori的同时治疗 (CT) 的疗效相当.
- 结合树脂添加剂STT的TT是一种建议的策略,以减轻过度使用抗生素.
- 在增加抗生素耐药性的背景下,多重PCR引导的量身定制治疗是一种可行的方法.
相关概念视频
Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
333
Helicobacter pylori, a resilient gram-negative bacterium, can thrive in the stomach's harsh, acidic environment. Infection with H. pylori leads to a cascade of events within the stomach lining. One of the critical disruptions caused by this bacterium is the interference with somatostatin production, a hormone responsible for regulating acid secretion. This interference tips the balance, escalating acid secretion and diminishing bicarbonate levels. This imbalance compromises the defensive...
333
Peptic Ulcer Disease IV: Management
75
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
75
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
97
Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
97
Gastritis III: Clinical Manifestations and Management
183
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
183
Combined Effects of Drugs: Synergism
3.8K
Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Such synergistic combinations...
3.8K
Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
361
Peptic ulcers, often induced by H. pylori infections or NSAID usage, arise from disruptions in the delicate balance of gastric acid production. Peptic ulcers stem from heightened gastric acid levels due to H. pylori infections or NSAID use. The protective mucus layer diminishes in the presence of these factors, allowing gastric acid to erode the stomach lining and form ulcers.
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
361


