Эрадикация Helicobacter pylori
В. В. Цуканов, В. Каспаров, В. Васютин, Л. Тонких
Abstract
В. В. Цуканов, В. Каспаров, В. Васютин, Л. Тонких
Abstract
General idea. The article is a review of data on Helicobacter pylori resistance to antibiotics, the impact of CYP2C19 polymorphism on the metabolism of proton pump inhibitors, and recent findings on the effectiveness of eradication. The authors conclude that triple therapy (proton pump inhibitor + clarithromycin + amoxicillin) is still the best option for first-line therapy in the eradication of Helicobacter pylori. For the purpose of eradication, rabeprazole could be a proton pump inhibitor of choice due to the fact that its metabolism is not dependent on the polymorphism of cytochrome. The optimal second-line therapy schemes are quadruple therapy and 10-day levofloxacin-based scheme. Additional therapy with probiotics containing lactobacilli could improve the effectiveness of eradication and reduce the incidence of side effects.
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General idea. The article is a review of data on Helicobacter pylori resistance to antibiotics, the impact of CYP2C19 polymorphism on the metabolism of proton pump inhibitors, and recent findings on the effectiveness of eradication. The authors conclude that triple therapy (proton pump inhibitor + clarithromycin + amoxicillin) is still the best option for first-line therapy in the eradication of Helicobacter pylori. For the purpose of eradication, rabeprazole could be a proton pump inhibitor of choice due to the fact that its metabolism is not dependent on the polymorphism of cytochrome. The optimal second-line therapy schemes are quadruple therapy and 10-day levofloxacin-based scheme. Additional therapy with probiotics containing lactobacilli could improve the effectiveness of eradication and reduce the incidence of side effects.
Key concepts: Rabeprazole, CYP2C19, Helicobacter pylori, Levofloxacin, Proton-pump inhibitor, Amoxicillin, Clarithromycin, Medicine