Orvosi Hetilap
Volume/Issue:
Volume 149: Issue 43
The new aspects of the eradication of Helicobacter pylori and the importance of bacterial resistance
Authors: Krisztina Hagymási and Zsolt Tulassay
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  • 1 Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi u. 46. 1088
  • 2 Magyar Tudományos Akadémia Molekuláris Medicina Kutatócsoport Budapest
DOI:
https://doi.org/10.1556/oh.2008.28460
Page Count:
2029–2035
Publication Date:
01 Oct 2008
Online Publication Date:
16 Oct 2008
Article Category:
Research Article
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A Helicobacter pylori -fertőzés első vonalbeli kezelését a hétnapos protonpumpagátló-alapú (PPI+clarythromycin+amoxycillin vagy metronidazol) kombinált terápia jelenti. A kezelés sikeressége a nemzetközi adatok alapján 80-90%, hazánkban 75%. Az esetek 10-25%-ában ismételt kezelés szükséges. A hazai gyakorlatban a második eradikációs kezelés 36%-ban, a harmadik csak 20%-ban sikeres. A Helicobacter pylori -ellenes kezelés sikeressége világszerte csökken, aminek a hátterében a bakteriális, főleg a clarythromycinrezisztencia gyakoribbá válása áll. Fontos tényező még a betegek nem megfelelő együttműködése és a gyógyszerhatóanyag farmakogenetikai, -kinetikai tulajdonságai. A gyakori metronidazol- és clarythromycinrezisztenciájú területeken az eredmények elfogadhatatlanul alacsonyak, új gyógyszerek, gyógyszer-kombinációk alkalmazása lenne kívánatos. Lehetséges megoldás a szekvenciális kezelés, illetve az újabb antibiotikumok (például levofloxacin) használata. Más természetes hatóanyagok alkalmazása (laktoferrin, probiotikumok, növényi kivonatok) további vizsgálatokat igényel.

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Cover Orvosi Hetilap
Orvosi Hetilap
Print ISSN:
0030-6002
Online ISSN:
1788-6120
Keywords:
Helicobacter pylori ; eradikáció; első-második vonalbeli kezelés; sikertelen kezelés; bakteriális rezisztencia; szekvenciális kezelés; Helicobacter pylori ; eradication; first and second line treatment; treatment failure; bacterial resistance; sequential therapy

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