PMID- 11249534
OWN - NLM
STAT- MEDLINE
DCOM- 20010405
LR  - 20190915
IS  - 1465-6566 (Print)
IS  - 1465-6566 (Linking)
VI  - 1
IP  - 3
DP  - 2000 Mar
TI  - Clarithromycin for Helicobacter pylori infection.
PG  - 507-14
AB  - Helicobacter pylori, a Gram-negative organism that survives in the deep mucus 
      layer and attaches to the gastric surface cells, is estimated to be present in up 
      to one-half of the US population. Chronic H. pylori infection causes chronic 
      gastritis, peptic ulcer diseases and even gastric cancer. Cure of the infection 
      leads to healing of gastric inflammation, prevention of development of peptic 
      ulcer, as well as accelerated healing of peptic ulcers, and prevention of ulcer 
      recurrence. Treatment of H. pylori has undergone substantial evolution over the 
      past decade. Despite the in vitro susceptibility, results from single or even 
      dual drug therapy is typically unsatisfactory and the best therapy is yet to be 
      defined. The best current therapies for H. pylori infection consist of a proton 
      pump inhibitor (PPI) or ranitidine bismuth citrate and two antibiotics (triple 
      therapies), or bismuth, tetracycline, metronidazole and a PPI (quadruple 
      therapy). Clarithromycin is one of the most useful antimicrobials against H. 
      pylori. It is an acid-stable macrolide with a broad spectrum of antibacterial 
      activity, well absorbed with a wide tissue distribution and with mild side 
      effects. Clarithromycin has a low minimum inhibitory concentration (MIC50) for H. 
      pylori and its effect is potentiated by acid inhibition. When combined with a PPI 
      or ranitidine bismuth citrate and amoxicillin or metronidazole, eradication rates 
      of more than 95% can be achieved with susceptible organisms. However, the 
      prevalence of primary and acquired clarithromycin resistance, which is due to 
      mutations within a conserved loop of 23S rRNA of H. pylori, is increasing. In 
      practice, the presence of clarithromycin resistance usually implies reduced 
      success when clarithromycin-containing regimes are used. There is a need for 
      improved therapies for H. pylori where antibiotic resistance is less of a 
      problem.
FAU - Leung, W K
AU  - Leung WK
AD  - Department of Medicine & Therapeutics, Prince of Wales Hospital, Shatin, Hong 
      Kong SARA.
FAU - Graham, D Y
AU  - Graham DY
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Expert Opin Pharmacother
JT  - Expert opinion on pharmacotherapy
JID - 100897346
RN  - 0 (Anti-Bacterial Agents)
RN  - H1250JIK0A (Clarithromycin)
SB  - IM
MH  - Anti-Bacterial Agents/pharmacology/*therapeutic use
MH  - Clarithromycin/pharmacology/*therapeutic use
MH  - Clinical Trials as Topic
MH  - Helicobacter Infections/*drug therapy
MH  - Helicobacter pylori/*drug effects
MH  - Humans
RF  - 46
EDAT- 2001/03/16 10:00
MHDA- 2001/04/06 10:01
CRDT- 2001/03/16 10:00
PHST- 2001/03/16 10:00 [pubmed]
PHST- 2001/04/06 10:01 [medline]
PHST- 2001/03/16 10:00 [entrez]
AID - 10.1517/14656566.1.3.507 [doi]
PST - ppublish
SO  - Expert Opin Pharmacother. 2000 Mar;1(3):507-14. doi: 10.1517/14656566.1.3.507.