PMID- 16181345
OWN - NLM
STAT- MEDLINE
DCOM- 20051115
LR  - 20131121
IS  - 1083-4389 (Print)
IS  - 1083-4389 (Linking)
VI  - 10
IP  - 5
DP  - 2005 Oct
TI  - Helicobacter pylori "rescue" therapy after failure of two eradication treatments.
PG  - 363-72
AB  - Nowadays, apart from having to know well first-line eradication regimens, we must 
      also be prepared to face Helicobacter pylori treatment failures. Therefore, in 
      designing a treatment strategy we should not focus on the results of primary 
      therapy alone, but also on the final--overall--eradication rate. After failure of 
      a combination of proton pump inhibitor (PPI), amoxicillin, and clarithromycin, 
      the use of empirical quadruple therapy (PPI-bismuth-tetracycline-metronidazole), 
      has been generally used as the optimal second-line therapy. Even after two 
      consecutive failures, several studies have demonstrated that H. pylori 
      eradication can finally be achieved in almost all patients if several "rescue" 
      therapies are consecutively given. It seems that performing culture even after a 
      second eradication failure may not be necessary, as it is possible to construct 
      an overall strategy to maximize H. pylori eradication, based on the different 
      possibilities of empirical treatment (when antibiotic susceptibilities are 
      unknown). Thus, if one does not want to perform culture before the administration 
      of the third treatment after failure of the first two, different empirical 
      treatments exist, including regimens based on: 1, amoxicillin (amoxicillin-PPI at 
      high doses); 2, amoxicillin plus tetracycline 
      (PPI-bismuth-tetracycline-amoxicillin, or 
      ranitidine-bismuth-citrate-tetracyline-amoxicillin); 3, rifabutin 
      (rifabutin-amoxicillin-PPI); 4, levofloxacin (levofloxacin-amoxicillin-PPI); and 
      5, furazolidone (furazolidone-bismuth-tetracycline-PPI).
FAU - Gisbert, Javier P
AU  - Gisbert JP
AD  - Department of Gastroenterology, University Hospital of La Princesa, Madrid, 
      Spain. gisbert@meditex.es
FAU - Pajares, Jose Maria
AU  - Pajares JM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - England
TA  - Helicobacter
JT  - Helicobacter
JID - 9605411
RN  - 0 (Antacids)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - U015TT5I8H (Bismuth)
SB  - IM
MH  - Antacids/therapeutic use
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Bismuth/therapeutic use
MH  - Drug Therapy, Combination
MH  - Helicobacter Infections/*drug therapy/microbiology
MH  - Helicobacter pylori/*drug effects
MH  - Humans
MH  - *Proton Pump Inhibitors
MH  - *Salvage Therapy
MH  - Treatment Failure
RF  - 71
EDAT- 2005/09/27 09:00
MHDA- 2005/11/16 09:00
CRDT- 2005/09/27 09:00
PHST- 2005/09/27 09:00 [pubmed]
PHST- 2005/11/16 09:00 [medline]
PHST- 2005/09/27 09:00 [entrez]
AID - HEL324 [pii]
AID - 10.1111/j.1523-5378.2005.00324.x [doi]
PST - ppublish
SO  - Helicobacter. 2005 Oct;10(5):363-72. doi: 10.1111/j.1523-5378.2005.00324.x.