rescue therapy for helicobacter pylori infection 20122012年救助治疗幽门螺杆菌感染.pdfVIP

Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2012, Article ID 974594, 12 pages doi:10.1155/2012/974594 Review Article Rescue Therapy for Helicobacter pylori Infection 2012 Javier P. Gisbert Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigacion Sanitaria Princesa (IP), ´ and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), 28006 Madrid, Spain ´ ´ ´ Correspondence should be addressed to Javier P. Gisbert, gisbert@meditex.es Received 5 October 2011; Accepted 10 December 2011 Academic Editor: Ping-I Hsu Copyright © 2012 Javier P. Gisbert. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Helicobacter pylori infection is the main cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. After 30 years of experience in H. pylori treatment, however, the ideal regimen to treat this infection has still to be found. Nowadays, apart from having to know well first-line eradication regimens, we must also be prepared to face treatment failures. In designing a treatment strategy, we should not only focus on the results of primary therapy alone but also on the final—overall—eradication rate. The choice of a “rescue” treatment depends on which treatment is used initially. If a first-line clarithromycin-based regimen was used, a second-line metronidazole-based treatment (quadruple therapy) may be used afterwards, and then a levofloxacin-