The successful isolation of Helicabacter pylori from the stomachs of patients with gastritis and peptic ulcer has revolutionized our concepts of the pathogenesis of gastritis, peptic ulcer, gastric cancer and gastric B cell lymphoma.
Eradication of H. pylori heals gastritis and H. pylori-related peptic ulcer.
After a successful cure of H. pylori infection, virtually no recurrence of duodenal ulcer is seen.
However, treatment to cure the infection has proved difficult.
Numerous clinical trials have been attempted, but as yet no ideal regimen has been identified.
Monotherapies have many drawbacks and should be avoided.
Dual therapies combining a proton pump inhibitor (PPI) and an antimicrobial agent provide higher eradication rates than those involving two antimicrobial agents.
Bismuth-based triple therapies are more effective than dual therapies in eradicating H. pylori infection.
However, poor compliance and frequent adverse effects have made these combinations less favourable in clinical practice.
Proton pump inhibitor-based triple therapies have shown more consistent and higher eradication rates with a short duration of treatment, good patient compliance, fewer side effects, prompt symptom relief and fast ulcer healing.
Results from PPI-based quadruple therapies are promising ; however, large multicentre clinical trials are needed to confirm the effect and the complex regimen again may compromise compliance outside of the clinical trial setting.
Eradication of H. (...)
Mots-clés Pascal : Ulcère, Gastroduodénal, Eradication, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Facteur risque, Forme clinique, Antibiotique, Récidive, Recommandation, Inhibiteur pompe proton, Etude comparative, Prévention, Homme, Article synthèse, Appareil digestif pathologie, Estomac pathologie, Intestin pathologie, Bactériose, Infection, Chimiothérapie, Economie santé, Antiulcéreux
Mots-clés Pascal anglais : Ulcer, Gastroduodenal, Eradication, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Risk factor, Clinical form, Antibiotic, Relapse, Recommendation, Proton pump inhibitor, Comparative study, Prevention, Human, Review, Digestive diseases, Gastric disease, Intestinal disease, Bacteriosis, Infection, Chemotherapy, Health economy, Antiulcer agent
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0438127
Code Inist : 002B05B02F. Création : 19/12/1997.