Theme |
Best Available Managements of Helicobacter pylori Gastritis |
Title |
Treatment for Patients Refractory to 1st and 2nd Line Regimens |
Author |
Takahisa Furuta |
Center for Clinical Research, Hamamatsu University School of Medicine |
Author |
Mitsushige Sugimoto |
First Department of Medicine, Hamamatsu University School of Medicine |
Author |
Takahiro Uotani |
First Department of Medicine, Hamamatsu University School of Medicine |
Author |
Shu Sahara |
First Department of Medicine, Hamamatsu University School of Medicine |
Author |
Hitomi Ichikawa |
First Department of Medicine, Hamamatsu University School of Medicine |
Author |
Takuma Kagami |
First Department of Medicine, Hamamatsu University School of Medicine |
[ Summary ] |
Recent reports have suggested that the candidates for third rescue regimens to treat H. pylori infection in Japan should be treated with fluoroquinolone-based regimens and dual therapy consisting of high doses of a proton pump inhibitor, and amoxicillin. Of fluoroquinolones, sitafloxacin has equally strong anti-H. pylori effects as AMPC and is effective in treating strains resistant to levofloxacin. Sitafloxacin-based regimens have been reported to yield relatively sufficient eradication rates when used for as the third line therapy. Dual therapy with high doses of a proton pump inhibitor and amoxicillin has also been reported to provide sufficient rescue rates. To achieve high rescue eradication rates, eradication regimens must be designed based on well-understanding of reasons for eradication failure, such as bacterial resistance patterns, as well as the pharmacological characteristics of agents used for H. pylori eradication therapy. |