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Achieving optimal eradication of H. pylori has proven difficult. Combination regimens that use two or three antibiotics with a proton pump inhibitor and/or bismuth are required to achieve adequate rates of eradication and to reduce the number of failures due to antibiotic resistance. In the United States, up to 50% of strains are resistant to ...
Eradication of H. pylori is recommended to treat the infection, including when advanced to peptic ulcer disease. The recommendations for first-line treatment is a quadruple therapy consisting of a proton-pump inhibitor, amoxicillin, clarithromycin, and metronidazole. Prior to treatment, testing is recommended to identify any pre-existing ...
Once the diagnosis of H. pylori is confirmed, the first-line treatment would be a triple regimen in which pantoprazole and clarithromycin are combined with either amoxicillin or metronidazole. This treatment regimen can be given for 7–14 days. However, its effectiveness in eradicating H. pylori has been reducing from 90% to 70%. However, the ...
Pantoprazole, sold under the brand name Protonix, among others, is a medication used for the treatment of stomach ulcers, short-term treatment of erosive esophagitis due to gastroesophageal reflux disease (GERD), maintenance of healing of erosive esophagitis, and pathological hypersecretory conditions including Zollinger–Ellison syndrome.
These infections can include Helicobacter pylori due to this species not favouring an acid environment, leading to an increased risk of ulcers and gastric cancer risk in genetically susceptible patients. [50] PPI use in people who have received attempted H. pylori eradication may also be associated with an increased risk of gastric cancer. [51]
Despite treatment, re-bleeding occurs in about 7–16% of those with upper GI bleeding. [3] In those with esophageal varices, bleeding occurs in about 5–15% a year and if they have bled once, there is a higher risk of further bleeding within six weeks. [13] Testing and treating H. pylori if found can prevent re-bleeding in those with peptic ...
World Congress of Gastroenterology recommends eradicating H. pylori to cure duodenal ulcers. [51] First report of resistance of H. pylori to the antibiotic metronidazole. [52] Resistance of H. pylori to treatment will lead to the development of many different antibiotic and proton pump inhibitor regimens for eradication. [53] 1992
Sucralfate is used for the treatment of active duodenal ulcers not related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs), as the mechanism behind these ulcers is due to acid oversecretion. [1] It is not FDA approved for gastric ulcers, but is widely used because of evidence of efficacy. [10]