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Hosp Pract (1995). 2011 Feb;39(1):133-40. doi: 10.3810/hp.2011.02.383.

A clinician's guide to salvage therapy for persistent Helicobacter pylori infection.

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  • 1Department of Internal Medicine, Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI 48109-5682, USA.

Abstract

Since its discovery in 1982, Helicobacter pylori has been established as a common cause of gastritis and peptic ulcer disease. H pylori infection is also closely associated with several gastric malignancies and has consequently been designated a human carcinogen. As these associations have become increasingly recognized and pursued, a growing challenge facing today's clinicians is the management of patients with persistent H pylori despite previous attempts to treat the infection. In developed countries, the most popular treatment regimen remains traditional triple therapy consisting of a proton pump inhibitor, clarithromycin, and amoxicillin for 7 to 14 days. Unfortunately, eradication rates with traditional triple therapy are disappointing, with infection persisting in as many as 25% of those treated. This article addresses the management of patients with persistent H pylori infection, including indications for confirmatory testing, reasons for treatment failure, and established and emerging salvage regimens for patients with persistent infection.

PMID:
21441768
[PubMed - indexed for MEDLINE]
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